Investigation of transvaginal minimal mesh surgical technique for recurrent POP cases after transvaginal mesh surgery

DOI
  • Kinno Kurenai
    Department of Urology,Toho University Ohashi Medical Center Department of Urology, Yotsuya Medical Cube
  • Fujisaki Akiko
    Department of Urology, Yotsuya Medical Cube
  • Shimoinaba Misa
    Department of Urology, Yotsuya Medical Cube
  • Honda Shuko
    Department of Urology, Yotsuya Medical Cube
  • Sekido Noritoshi
    Department of Urology,Toho University Ohashi Medical Center
  • Yoshimura Yasukuni
    Department of Urology, Yotsuya Medical Cube FemalePelvic Health Center, Showa University Northern Yokohama Hospital

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  • 経腟メッシュ手術後再発症例に対する経腟ミニマルメッシュ手術の検討

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Abstract

<p>Objectives: Transvaginal mesh (TVM) surgery remains a widely used key procedure in Japan due to its favorable outcomes in repairing pelvic organ prolapse (POP). However, POP can frequently reoccur after repair, and so countermeasures are needed. Here, we report on outcomes of TVM surgery using a reduced-size Uphold™-type mesh (transvaginal minimal mesh surgery) in a procedure that does not involve passage of mesh arms through the obturator foramina, as treatment for recurrent POP.</p><p>Methods: We retrospectively examined 11 patients who had undergone transvaginal minimal mesh surgery for recurrent POP after initial TVM surgery.</p><p>Results: Median age at time of initial TVM surgery was 65 [range, 51-77]years; 7 patients had the procedure at other facilities, and 4 had undergone the procedure at our hospital. The initial TVM procedure used a Prolift™-type mesh, involved passage of mesh arms through the obturator foramina, and was performed in 10 patients; the minimal mesh procedure was performed in 1 patient. Median age at the time of TVM for recurrent POP was 69 [range, 60-79]years, median operative time was 56 [range, 34-91] min, and median blood loss was 20 [range, 10-65]mL. Sacrospinous ligament puncture was successful even when the ligament had been used in the initial procedure. No damage to adjacent organs, POP recurrence, or exposure of the mesh through the vaginal wall was observed during follow-up (median, 6 [range, 118] months).</p><p>Conclusion: Transvaginal minimal mesh surgery for POP recurrence can be performed safely and completed within a short operative time.</p>

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