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Ng, Christopher CM, and Christopher YL Chong. "The Effectiveness of Transvaginal Anterior Colporrhaphy Reinforced with Polypropylene Mesh in the Treatment of Severe Cystoceles." Annals of the Academy of Medicine, Singapore 35, no. 12 (2006): 875–81. http://dx.doi.org/10.47102/annals-acadmedsg.v35n12p875.
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Introduction: Grade 4 cystoceles are among the most challenging to achieve a successful repair for gynaecologists. The high rate of recurrence of severe prolapse encouraged surgeons to use meshes. Only recently have meshes been used transvaginally for pelvic organ prolapse. The aim of our pilot study was therefore to determine the effectiveness of transvaginal anterior colporrhaphy reinforced with prolene mesh in the treatment of severe or recurrent cystoceles by looking at their primary surgical outcomes as well as their complications. Materials and Methods: This was a retrospective study conducted by the urogynaecology unit at KK Women’s and Children’s Hospital (KKWCH) in Singapore based on operations performed from April 2002 to December 2003. The inclusion criterion was that women had to have at least a grade 4 or recurrent grade 3 cystocele and had undergone a vaginal anterior colporrhaphy reinforced with prolene mesh. The women were further subdivided into 3 groups depending on whether vaginal hysterectomies were performed or not as well as the absence or presence of the uterus. Results: Thirty-seven patients with severe cystoceles underwent this procedure. The 3 mean follow-up times for the 3 groups ranged from 14.4 to 19.2 months (range, 2 to 32). Overall for the 3 groups, 75.7% were cured with no or grade 1 cystocele, 18.9% had asymptomatic grade 2 cystocele while 5.4% developed grade 3 or 4 cystocele. There were no mesh erosions. Conclusion: Transvaginal anterior colporrhaphy reinforced with a tension-free prolene mesh in the treatment of severe or recurrent cystoceles is simple, safe, easily performed and is associated with a low failure rate and morbidity. Key words: Morbidity, Prolapse, Retrospective study, Surgical mesh
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Saha, Mukti Rani, Tapan Kumer Saha, Md Al Kamal Abdul Wahab, and Md Rajibul Haque. "Uterovaginal prolapse with multiple Vesical calculi: A rare case report." Journal of Dhaka Medical College 25, no. 1 (2017): 77–79. http://dx.doi.org/10.3329/jdmc.v25i1.33962.
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Uterine prolase is a common gynaecological disease .It is usually associated with cystocele and or rectocele as well as enterocele. Recurrent urinary tract infections may occur in chronically unreduced cystocele leading to calculus formation,cystitis,pyelitis,pyelonephritis and renal failure.We report a case of a 70 years old multiparous lady with third degree uterovaginal prolapse for twenty years, presence of multiple vesical calculus in the cystocele was noted on X-ray pelvis while undergoing investigation.Suprapubic cystolithotomy followed by vaginal hysterectomy with pelvic floor repair was done. Multiple vesical calculus were removed. Postoperative course was uneventful and she was discharged on 10th post-operative day. Patient is still on follow up with good urinary function and no recurrent UTI.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 77-79
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Domány, B., and J. Bódis. "Colposuspension and the possibility of recurrent cystocele." American Journal of Obstetrics and Gynecology 177, no. 4 (1997): 982–83. http://dx.doi.org/10.1016/s0002-9378(97)70319-3.
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Shpikina, A. D., M. E. Enikeev, O. V. Snurnitsyna, et al. "Site-specific correction of urogenital prolapse with bilateral sacrospinous hysteropexy versus pelvic floor reconstruction with the six-armed mesh implant: two-year follow-up results." Russian Medical Inquiry 9, no. 4 (2025): 241–48. https://doi.org/10.32364/2587-6821-2025-9-4-9.
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Aim: to compare the anatomical and functional outcomes of site-specific correction of anterior-apical prolapse using bilateral sacrospinous hysteropexy versus correction of prolapse using the six-armed OPUR® mesh implant. Materials and Patients: a total of 158 patients (mean age: 63 years) with stage II–III anterior-apical prolapse according to the Pelvic Organ Prolapse Quantification System (POP-Q) were included in this study. Site-specific prolapse correction with bilateral sacrospinous hysteropexy was performed in 82 patients (group I), while 76 patients received pelvic organ prolapse (POP) correction using the six-armed mesh implant (group II). All patients underwent gynecological examination and prolapse staging prior to surgery, and at 1, 3, 6, and 12 months, as well as annually thereafter The primary endpoint was the rate of prolapse recurrence after surgical treatment Secondary endpoints included the rate of peri- and postoperative complications, chronic pelvic pain, assessment of urinary and sexual function. Results: at 6 and 8 months, prolapse recurrence (hysteroptosis) developed in 2 (2.4%) patients in group I, and recurrent cystocele was observed in 1 (1.2%) of them. In group II, recurrence of uterine prolapse was detected in 2 (2.6%) patients at 6 months after surgery, and recurrent cystocele was observed at 23 months postoperatively. De novo continence was achieved in 19 (52.8%) of 36 patients with prior stress urinary incontinence. Meanwhile, de novo incontinence was diagnosed in 24 (15.2%) of all study participants. Obstructive urination resolved in 100% of cases; urgent urination persisted in 15 (9.4%) patients. Conclusion: both techniques are equally effective in eliminating defects of the anterior and apical pelvic fascia, reliably correcting cystocele and uterine prolapse Bilateral sacrospinous hysteropexy with pelvic fascia reconstruction enables reduction of the amount of mesh implant used, while "notorious" mesh-related complications were not observed with either technique. KEYWORDS: urogenital prolapse, site-specific correction, mesh implant, bilateral sacrospinous hysteropexy. FOR CITATION: Shpikina A.D., Enikeev M.E., Snurnitsyna O.V., Burakova L.I., Babaevskaya D.I., Abdurashitova V.Sh., Slobodyanyuk B.A., Dobrokhotova Yu.E., Nikitin A.N., Rapoport L.M. Site-specific correction of urogenital prolapse with bilateral sacrospinous hysteropexy versus pelvic floor reconstruction with the six-armed mesh implant: two-year follow-up results. Russian Medical Inquiry. 2025;9(4):241–248 (in Russ.). DOI: 10.32364/2587-6821-2025-9-4-9
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Kessels, Imke, Sander van Kuijk, Tineke Vergeldt, et al. "The External Validation of a Multivariable Prediction Model for Recurrent Pelvic Organ Prolapse After Native Tissue Repair: A Prospective Cohort Study." Journal of Clinical Medicine 14, no. 2 (2025): 531. https://doi.org/10.3390/jcm14020531.
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Background/Objectives: A prediction model for anatomical cystocele recurrence after native tissue repair was developed and internally validated in 2016. This model estimates a patients’ individual risk of recurrence and can be used for counseling. Before implementation in urogynecological clinical practice, external validation is needed. The aim of this study was to assess the external validity of this previously developed prediction model. The secondary aim was to test the performance of this model with a composite and subjective outcome of pelvic organ prolapse (POP) recurrence. Furthermore, the aim was to investigate whether risk factors for POP recurrence were in line with the population in which the original model was developed. Methods: In this prospective multicenter cohort study, 246 patients who underwent anterior colporrhaphy were included. Inclusion criteria were patients scheduled to undergo a primary anterior colporrhaphy (with a POP Quantification (POPQ) stage ≥ 2 cystocele). A combination of a primary anterior colporrhaphy with other POP or incontinence surgery (without the use of vaginal or abdominal mesh material) was permitted. Patients with prolapse or incontinence surgery prior to index surgery could not participate. All patients filled in questionnaires, pelvic floor ultrasound was performed preoperatively, and data from the medical file concerning POPQ stage and obstetric and general history were obtained. Results: Thirty women (12.2%) were lost at follow up. Anatomical cystocele recurrence was present in 107/216 (49.5%), subjective recurrence in 19/208 (9.1%), and 39/219 (17.8%) patients met the criteria for composite outcome. The area under the receiver operating characteristic curves for anatomical, composite, and subjective recurrence were 65.5% (95% CI: 58.7–72.4), 55.8% (95% CI 47.3–64.3%, NS), and 55.1% (95% CI 45.1–65.2%), respectively. In the multivariable analysis, preoperative cystocele stage 3 or 4 and a complete levator defect on ultrasound were independent risk factors for anatomical recurrence. For composite recurrence, younger age and an active employment status were only risk factors in univariable analysis. No significant risk factors for subjective recurrence could be identified. Conclusions: This external validation study showed a moderate performance for a prediction model for anatomical recurrence. The model cannot be used for a composite or subjective outcome prediction because of poor performance. For composite and subjective recurrence, new prediction models need to be developed.
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Snurnitsyna, O. V., A. N. Nikitin, M. V. Lobanov, Zh Sh Inoyatov, L. M. Rapoport, and M. E. Enikeev. "Transvaginal mesh-reconstruction of anterior apical prolapse: a selective implant choosing approach." Vestnik Urologii 10, no. 1 (2022): 60–69. http://dx.doi.org/10.21886/2308-6424-2022-10-1-60-69.
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Introduction. Transvaginal mesh-reconstruction of urogenital prolapse remains a controversial trend in modern urogynecology. We have seen growth in transvaginal mesh surgery since 2004, followed by a sharp decline after 2011 due to FDA restrictions related to imperfections in previously available prostheses and implantation techniques. Improving the efficacy and minimizing complications of transvaginal mesh-surgery is at the forefront of research in the field of modern urogynecology.Purpose of the study. To optimize the indications for transvaginal mesh-reconstruction of anterior apical prolapse.Materials and methods. The study enrolled 375 patients with anterior apical prolapse. The grade of prolapse was assessed using POP-Q. In patients with endopelvic pelvic fascia insufficiency, severe cystocele (Aa ≥ +1) and hysteroptosis grade II – IV, the correction was carried out using the six-arm OPUR® («ABISS», Saint-Étienne, France). lightweight polypropylene monofilament implant (n = 290). When the cystocele was not prominent (Aa ≤ -1) and grade III – IV hysteroptosis, posterior sacrospinal hysteropexy was preferred with the CYRENE® («ABISS», Saint-Étienne, France) tape (n = 85). In 35 patients, the operation was combined with anterior colporrhaphy. In 5 patients, a simultaneous conization/amputation of the cervix was performed. The examination was performed 1 month after surgery and then annually. Prolapse ≥ grade II was as recurrent. The follow-up period of 67 patients was more than 4 years.Results. After OPUR® prosthesis implantation, recurrent hysteroptosis was detected in 6 women with cervical hypertrophy / elongation within a period of 1 mo to 3.5 yr and cystocele in 4 patients. The efficacy was 96%. In 9 patients, an postoperative ischuria was found associated with extensive dissection and hypotension of the bladder wall due to chronic urinary retention in severe cystocele. Urination improved in 88% of cases. In the remaining cases, long-term mediator and hormone replacement therapy were continued., One recurrent hysteroptosis was observed during the implantation of the CYRENE® prosthesis. No damage to the bladder was observed. Acute urinary retention was detected in 1 case, which resolved after intermittent catheterization. Conclusion. The availability of 2 types of transvaginal prostheses for various degrees and configurations of urogenital prolapses allows a differentiated approach to their choice. Both prostheses suggest reliable «reconstruction-imitation» of the sacroiliac ligament by sacrospinal hysteropexy. If necessary, the operation can be supplemented with anterior colporrhaphy. The prevalence of anterior prolapse with endopelvic fascia insufficiency requires more extensive reconstruction, which can be performed relatively safely and effectively by implantation of a 6-arm OPUR® prosthesis.
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Moore, Robert D., and John R. Miklos. "Vaginal Repair of Cystocele with Anterior Wall Mesh via Transobturator Route: Efficacy and Complications with Up to 3-Year Followup." Advances in Urology 2009 (2009): 1–8. http://dx.doi.org/10.1155/2009/743831.
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Study Objective. The objective of this study was to report on the safety and efficacy of cystocele repair with anterior wall mesh placed via a transobturator route (Perigee system, AMS, Minnetonka, MN).Design. Single center retrospective study.Setting. Single center hospital setting and Urogynecology practice in the United States.Patients. 77 women presenting with symptomatic anterior wall prolapse.Intervention. Repair of cystocele with an anterior wall Type I soft-polypropylene mesh placed via a transobturator approach. Concomitant procedures in other compartment were also completed as indicated.Measurements and Main Results. 77 women underwent the Perigee procedure at our institution over a 2-year period. The mesh was attached to the pelvic sidewalls at the level of the bladder neck and near the ischial spine apically with needles passed through the groins and obturator space. Mean follow-up was 18.2 months (range 3–36 months). Objective cure rate was 93%. Subjectively only two patients have had recurrent symptoms of prolapse, and only 1 of these has required repeat surgery for cystocele. Mesh exposure vaginally occurred in 5 patients (6.5%); however all were treated with estrogen and/or local excision of exposed mesh and had no further sequelae. There were no incidences of chronic pain, infection, or abscess, and no patient required complete mesh removal for infection, pain, or extrusion.Conclusion. In select patients with anterior wall prolapse, repair with mesh augmentation via the transobturator route is a safe and effective procedure with up to 3 years of follow-up.
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Cundiff, Geoffrey. "Cystocele repair with fascial reinforcement using autologous fascia lata for recurrent prolapse." American Journal of Obstetrics and Gynecology 226, no. 3 (2022): S1367. http://dx.doi.org/10.1016/j.ajog.2021.12.222.
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Borrego-Jimenez, Pedro-Santiago, Bárbara-Yolanda Padilla-Fernandez, Sebastián Valverde-Martinez, et al. "Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele." Journal of Clinical Medicine 9, no. 10 (2020): 3310. http://dx.doi.org/10.3390/jcm9103310.
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Objectives: to demonstrate the benefits of physiotherapy (PT) with pelvic floor biofeedback (BFB) in improving health-related quality of life when used as a complementary therapy after surgical treatment of cystocele, in cases in which perineal pain or discomfort persists. Materials and methods: prospective observational study in 226 women who received complementary therapy after surgical treatment of cystocele due to persistent perineal discomfort or pain. Groups: GA (n = 78): women treated with 25 mg of oral pregabalin every 12 h plus BFB, consisting of 20 once-weekly therapy sessions, each 20 min long, with perineal pregelled surface electrodes connected to a screen which provides visual feedback; GB (n = 148): women treated with oral pregabalin 25 mg every 12 h without BFB. Variables: age, body mass index (BMI), time since onset of cystocele prior to surgery (TO), SF-36 health-related quality of life survey score, diseases and concomitant health conditions, follow-up time, success, or failure of postsurgical treatment. Results: average age 67.88 years (SD 12.33, 30–88), with no difference between GA and GB. Average body mass index (BMI) 27.08 (SD 0.45, 18.74–46.22), with no difference between GA and GB. Time since onset of cystocele prior to surgery (TO) was 6.61 years (SD 0.6), with no difference between GA and GB. Pretreatment SF-36 score was lower in GA success than GB success. Treatment was successful in 141 (63.20%) women and failed in 82 (36.80%). PT and age were the main predictors of success, and the least important were pretreatment SF-36 and the time elapsed after the intervention. In GA, 63 women (80.80%) showed improvement while 15 (19.20%) did not. Age was the main predictor of treatment success, while the least important was BMI. In GB, 78 women (53.80%) showed improvement while 67 (46.20%) did not improve. The main predictor was time since cystocele onset prior to surgery, while the least important was age. The odds ratio (OR) of improving quality of life for each unit increase in SF-36 was 11.5% (OR = 0.115) in all patients, with no difference between success and failure; in GA it was 23.80% (OR = 0.238), with a difference between success and failure; in GB it was 11.11% (OR = 0.111), with no difference between success and failure. GA and GB success had more history of eutocic delivery. GA success had more rUTI. GB success and GA failure both had more history of UI corrective surgery. The “failure” outcome had a higher number of patients with more than two concomitant pathological conditions. Conclusions: BFB as an adjunctive treatment improves quality of life in women suffering from persistent discomfort after surgery for cystocele. Young women who meet the criteria for recurrent urinary tract infection or who have a history of eutocic delivery show greater improvement. Body mass index does not influence response to treatment, while the presence of more than two concomitant conditions indicates a poor prognosis for improving quality of life.
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Dr, Salman Hussain Dr Nuzha Sajjad Dr Sufyan Akram. "RECURRENT URINARY TRACT INFECTION IN WOMEN." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES o6, no. 07 (2019): 13888–92. https://doi.org/10.5281/zenodo.3354985.
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<strong><em>Aim:</em></strong><em> To evaluate factors associated with recurrent urinary tract infection (UTI) in postmenopausal women. </em> <strong><em>Method:</em></strong><em> a case-control study was conducted that comparing on 149 postmenopausal women who had a history of recurrent UTI (case patients) with 53 age-matched women without a history of UTI (control patients). Questionnaire was filled by each women providing demographic data, history and clinical characteristics of prior infections, and information regarding risk factors for UTI. In addition, each patient underwent a gynecologic evaluation, renal ultrasound and urine flow studies, and blood group and secretor status testing. </em> <strong><em>Results and conclusion</em></strong><em> Three urologic factors—namely, incontinence (41% of case patients vs. 9.0% of control patients; ), presence of a cystocele (19% vs. 0%; P ! .001 P ! .001), and postvoiding residual urine (28% vs. 2.0%; )—were all strongly as- P = .00008 sociated with recurrent UTI. Multivariate analysis showed that urinary incontinence (odds ratio [OR], 5.79; 95% confidence interval [CI], 2.05–16.42; ), a history of UTI before P = .0009 menopause (OR, 4.85; 95% CI, 1.7–13.84; ), and nonsecretor status (OR, 2.9; 95% P = .003 CI, 1.28–6.25; ) were most strongly associated with recurrent UTI in postmenopausal P = .005 women.</em>
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Weber, Anne M. "Polyglactin 910 mesh during anterior and posterior colporrhaphy reduced the risk of recurrent cystocele." Evidence-based Obstetrics & Gynecology 4, no. 1 (2002): 42–43. http://dx.doi.org/10.1054/ebog.2002.0021.
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Acharyya, R., and J. Gandhi. "P619 Perigee mesh insertion for the repair of recurrent or large cystocele - Hull experience." International Journal of Gynecology & Obstetrics 107 (October 2009): S588. http://dx.doi.org/10.1016/s0020-7292(09)62110-x.
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Kohli, Neeraj, Eddie H. M. Sze, Todd W. Roat, and Mickey M. Karram. "Incidence of recurrent cystocele after anterior colporrhaphy with and without concomitant transvaginal needle suspension." American Journal of Obstetrics and Gynecology 175, no. 6 (1996): 1476–82. http://dx.doi.org/10.1016/s0002-9378(96)70093-5.
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Nüssler, Emil Karl, Susanne Greisen, Ulrik Schiøler Kesmodel, Mats Löfgren, Karl Møller Bek, and Marianne Glavind-Kristensen. "Operation for recurrent cystocele with anterior colporrhaphy or non-absorbable mesh: patient reported outcomes." International Urogynecology Journal 24, no. 11 (2013): 1925–31. http://dx.doi.org/10.1007/s00192-013-2110-2.
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Marschke, J., K. Beilecke, and R. Tunn. "Minimally invasive mesh preserving surgical technique to treat recurrent cystocele after transvaginal mesh interposition." European Journal of Obstetrics & Gynecology and Reproductive Biology 200 (May 2016): 130. http://dx.doi.org/10.1016/j.ejogrb.2016.03.049.
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Mahajan, Shreya, Shalini Mahana Valecha, and Disha Andhiwal Rajput. "High sacrospinous fixation for managing recurrent pelvic organ prolapse, an innovative approach: a case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 13, no. 12 (2024): 3761–64. http://dx.doi.org/10.18203/2320-1770.ijrcog20243621.
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A case of 45-year-old female patient with recurrent pelvic organ prolapse (POP) following a previous vaginal hysterectomy and pelvic floor repair. Despite initial relief for 4 years, she again developed complaints of something coming out of vagina, leading to significant discomfort and functional impairment. Physical examination revealed complete vaginal vault eventration with cystocele and rectocele, along with a deficient perineum Preoperative evaluations confirmed the necessity and feasibility of surgical intervention. A specifically tailored approach was used to treat multiple pelvic floor defects using high sacrospinous fixation combined with Anterior colporrhaphy, posterior colpoperineorrhaphy and enterocoele repair. Postoperative outcomes demonstrated substantial improvement in symptoms and functional recovery, and overall restoration of pelvic floor supports. High sacrospinous ligament fixation (SSLF) is a safe, effective, and simple procedure for prevention and treatment of vaginal vault prolapse.
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Pennisi, M. "Surgery by vaginal approach in stress urinary incontinence: Lahodny bladder suspension." Urologia Journal 65, no. 1 (1998): 24–27. http://dx.doi.org/10.1177/039156039806500103.
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Urogenital prolapse and urinary incontinence secondary to multiple defects of the pelvic floor (cystocele caused by lateral and central defect of the pubocervical fascia, hysterocele, rectocele) may also be successfully treated by vaginal approach only. From October ‘95 to September ‘97, 78 women underwent colpohysterectomy, Lahodny bladder suspension and perineoplasty and in 15 of them the vaginal cupola was anchored to the right sacrospinous ligament. In another 3 women Lahodny's procedure was associated with just perineoplasty, since there was a cystocele caused by lateral and central defect of the pubocervical fascia and a rectocele, while the uterus was fixed in place. Prior to operation the 81 patients underwent a colpocytological exam, pelvic ultrasound, a urodynamic exam with flow pressure study and assessment of the leak pressure with Valsalva manoeuvre, and in the cases of constipation or fecal incontinence, coloproctological investigation. The suprapubic catheter that was always positioned at the end of the operation was on average removed on the 10th day, upon the disappearance of significant post-micturitional residue. There is no micturitional difficulty in any patient. Given the short follow-up, the results are given of the 44 women observed for at least one year, 40 of whom are continent. Recurrent prolapse was found in 8 cases, 2 involving the anterior, 40 the rear and 2 the central wall. No patient has had a return of stress incontinence.
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Orazov, Mekan R., Viktor E. Radzinsky, and Farida F. Minnullina. "Surgical treatment of recurrent pelvic organ prolapse: what is important to know?" Clinical review for general practice 6, no. 1 (2025): 106–12. https://doi.org/10.47407/kr2024.6.1.00558.
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High rate of recurrence after surgical correction remains the key problem of the pelvic organ prolapse (POP) treatment, while the key objective is the search for the ways to improve surgical techniques. Various surgical approaches, including minimally invasive, involving the use of mesh implants or native tissues have been developed, but neither patients, nor surgeons are satisfied with the results. Aim: to analyze available scientific data on the efficacy and safety of surgical correction methods in terms of genital prolapse recurrence. Methods. Analysis of scientific papers published in the ELibrary, PubMed, CochraneLibrary, Science Direct databases in 2010–2024 for the keywords “pelvic organ prolapse/пролапс тазовых органов”, “rectocele/ректоцеле”, “cystocele/цистоцеле”, “apical prolapse/апикальный пролапс”, “recurrence/рецидив”, “surgical treatment/оперативное лечение” was performed. Results. To date, no perfect surgical approach to treatment of POP has been developed; no optimal surgical procedures for correction of primary and recurrent POP allowing one to avoid the disease progression have been proposed. A comprehensive personalized approach based on thorough assessment of the pelvic floor condition taking into account all the existing risk factors of primary POP or new disease progression factors in case of recurrence is the key to reducing the POP recurrence rate. Conclusion. Verification of fascial defects during preoperative and intraoperative periods is believed to be critical for improvement of the POP surgical treatment outcomes. Sufficient extent of surgical intervention, elimination of all fascial defects, optimal use of MESH technologies might improve anatomical and subjective operative results, as well as reduce the risk of recurrence. The use of synthetic implants in a number of studies has proven to be effective, regardless of the ongoing discussions about safety of such methods. It is necessary to continue the research on a large sample, since it will make it possible to improve the long-term treatment outcomes.
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Lin, Chia-Ju, Chih-Ku Liu, Hsiao-Yun Hsieh, Ming-Jer Chen, and Ching-Pei Tsai. "Modified Vaginal Mesh Procedure with DynaMesh®-PR4 for the Treatment of Anterior/Apical Vaginal Prolapse." Diagnostics 13, no. 18 (2023): 2991. http://dx.doi.org/10.3390/diagnostics13182991.
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(1) Background: Treating female pelvic organ prolapse (POP) is challenging. Surgical meshes have been used in transvaginal surgeries since the 1990s, but complications such as mesh exposure and infection have been reported. Polyvinylidene fluoride (PVDF) mesh, known for its stability and non-reactive properties, has shown promise in urogynecological surgeries. (2) Methods: A retrospective analysis was conducted on 27 patients who underwent a modified PVDF vaginal mesh repair procedure using DynaMesh®-PR4 and combined trans-obturator and sacrospinous fixation techniques. Additional surgeries were performed as needed. (3) Results: The mean operation time was 56.7 min, and the mean blood loss was 66.7 mL. The average hospitalization period was 4.2 days with Foley catheter removal after 2 days. Patients experienced lower pain scores from the day of the operation to the following day. Postoperative follow-up revealed that 85.2% of patients achieved anatomic success, with 14.8% experiencing recurrent stage II cystocele. No recurrence of apical prolapse was observed. Complications were rare, with one case (3.7%) of asymptomatic mesh protrusion. (4) Conclusions: The modified vaginal mesh procedure using DynaMesh®-PR4 showed favorable outcomes with a short operation time, low recurrence rate, rare complications, and improved functional outcomes. This surgical option could be considered for anterior and apical pelvic organ prolapse in women.
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Cervigni, Mauro, Franca Natale, Jennifer Weir, and Francesco Antomarchi. "1284: Prospective Randomized Controlled Study of the Use of a Synthetic Mesh (Gynemesh®) Versus a Biological Mesh (Pelvicol®) in Recurrent Cystocele." Journal of Urology 177, no. 4S (2007): 423. http://dx.doi.org/10.1016/s0022-5347(18)31498-8.
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Argirovic, Rajka. "Posthysterectomy vault prolapse of vaginal walls: Choice of operating procedure." Srpski arhiv za celokupno lekarstvo 140, no. 9-10 (2012): 666–72. http://dx.doi.org/10.2298/sarh1210666a.
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Post-hysterectomy vaginal vault prolapse is a common complication following different types of hysterectomy with a negative impact on the woman?s quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanisms for the uterus and vagina is important in order to make the right choice of the corrective procedure and also to minimize the risk of posthysterectomy occurrence of vault prolapse. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced in hysterectomy to prevent vault prolapse. Vaginal vault repair can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures. The vaginal approach for vault prolapse is superior to the abdominal approach in terms of complication rates, blood loss, postoperative discomfort, length of hospital stay and costeffectiveness. Moreover, it allows the simultaneous repair of all coexistent pelvic floor defects, such as cystocele, enterocele and rectocele. Abdominal sacrocolpopexy is associated with a lower rate of recurrent vault prolapse and dyspareunia than the vaginal sacrospinous colpopexy. Other less commonly performed procedures include uterosacral ligament suspension and illeococcygeal fixation with a high risk of ureteric injury. Surgical mesh of non-absorbent material is gaining in popularity and preliminary data from vaginal mesh procedures is encouraging.
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Joukhadar, Ralf, Gabriele Meyberg-Solomayer, Amr Hamza, et al. "A Novel Operative Procedure for Pelvic Organ Prolapse Utilizing a MRI-Visible Mesh Implant: Safety and Outcome of Modified Laparoscopic Bilateral Sacropexy." BioMed Research International 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/860784.
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Introduction. Sacropexy is a generally applied treatment of prolapse, yet there are known possible complications of it. An essential need exists for better alloplastic materials.Methods. Between April 2013 and June 2014, we performed a modified laparoscopic bilateral sacropexy (MLBS) in 10 patients using a MRI-visible PVDF mesh implant. Selected patients had prolapse POP-Q stages II-III and concomitant OAB. We studied surgery-related morbidity, anatomical and functional outcome, and mesh-visibility in MRI. Mean follow-up was 7.4 months.Results. Concomitant colporrhaphy was conducted in 1/10 patients. Anatomical success was defined as POP-Q stage 0-I. Apical success rate was 100% and remained stable. A recurrent cystocele was seen in 1/10 patients during follow-up without need for intervention. Out of 6 (6/10) patients with preoperative SUI, 5/6 were healed and 1/6 persisted. De-novo SUI was seen in 1/10 patients. Complications requiring a relaparoscopy were seen in 2/10 patients. 8/10 patients with OAB were relieved postoperatively. The first in-human magnetic resonance visualization of a prolapse mesh implant was performed and showed good quality of visualization.Conclusion. MLBS is a feasible and safe procedure with favorable anatomical and functional outcome and good concomitant healing rates of SUI and OAB. Prospective data and larger samples are required.
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Gosavi, Amrapali D., and Sanjay P. Dhangar. "A prospective study of laproscopic paravaginal repair of cystocoele: our experience." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 9 (2021): 3472. http://dx.doi.org/10.18203/2320-1770.ijrcog20213470.
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Background: Cystocele is diagnosed clinically by vaginal examination approaches using the pelvic organ prolapse quantifications system (POP-Q) of classification. Abdominal and laproscopic are now used due to high failure rate involving the transvaginal repair. Laproscopic repair involves approximation of the vaginal sub-epithelial tissue with the Cooper’s ligament using non-absorbable suture.Methods: This was a prospective observational study from June 2016 to May 2020 over women with symptomatic cystocele of grade ≥2. All patients were preoperatively and post-operatively assessed with quality-of-life questionnaires, pelvic organ prolapse distress inventory-6 (POPDI-6) and urinary distress inventory short form. Clinical examination was done with and without Valsalva maneuver. POP classification was used for grading the prolapse. All patients were assessed for any voiding difficulty after surgery, at one week, three months, six months and 12 months.Results: The median age of patient was 55.5 years. 90.9% patients presented with urinary symptoms. 54.5% patients underwent hysterectomy. The mean blood loss was 55 cc. The anatomic cure rate for cystocoele was 100% in our study in 1 week, 3 months and 6 months post-operatively. There was significant improvement in the quality-of-life scores. Overall, symptomatic relief was seen in 90.9% patients at first week, 95.4% at 3 months, 95.4% at 6 and 12 months follow up. Urinary symptoms were relieved in all patients at first follow up after 7 days, and 95.4% patients during 3, 6 and 12 months follow up.Conclusions: Laproscopic paravaginal cystocoele repair is safe, effective and an easy procedure with good results. The procedure is easy to learn and master with low recurrence rates.
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Salman, Süleyman, Bülent Babaoglu, Serkan Kumbasar, et al. "Comparison of Unilateral and Bilateral Sacrospinous Ligament Fixation Using Minimally Invasive Anchorage." Geburtshilfe und Frauenheilkunde 79, no. 09 (2019): 976–82. http://dx.doi.org/10.1055/a-0846-5726.
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Abstract Objective The aim of this study was to determine the effectiveness of a newly developed anchoring system for unilateral sacrospinous ligament fixation (USSLF) and bilateral sacrospinous ligament fixation (BSSLF) procedures. Material and Methods Ninety-three patients with pelvic prolapse who were treated surgically with the Anchorsure System® between 2013 and 2018 were included in the study. USSLF was performed in 52 patients (group 1), and BSSLF was performed in 41 patients (group 2). Pelvic organ prolapse was assessed preoperatively and 6 months postoperatively. Results There were no significant differences between groups 1 and 2 with regard to age, parity, and demographic characteristics. Anatomical improvement rates were similar, irrespective of the type of SSLF used. No bleeding requiring blood transfusion or organ injuries occurred in any patient. Three patients in the group that received BSSLF developed small asymptomatic cystoceles (grade 1 to 2); there was no recurrence of rectoceles or enteroceles. Mild cystocele was found in 1 patient from the USSLF group. There was no significant difference between the groups with respect to the recurrence of cystocele. Recurrence of vaginal vault prolapse was found in 2 patients from the USSLF group (3.84%). There was no significant difference between the groups with regard to recurrence. Febrile morbidity, clinical outcomes, blood loss, duration of operation, intraoperative complications, and length of hospital stay were similar for the two groups. Conclusions Unilateral and bilateral SSLF techniques produce similar clinical outcomes. USSLF and BSSLF performed using the new anchoring system are safe and effective methods to treat pelvic organ prolapse.
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Natale, F., C. La Penna, A. Padoa, M. Agostini, E. De Simone, and M. Cervigni. "A prospective, randomized, controlled study comparing Gynemesh®, a synthetic mesh, and Pelvicol®, a biologic graft, in the surgical treatment of recurrent cystocele." International Urogynecology Journal 20, no. 1 (2008): 75–81. http://dx.doi.org/10.1007/s00192-008-0732-6.
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Vergeldt, Tineke F. M., Sander M. J. van Kuijk, Kim J. B. Notten, Kirsten B. Kluivers, and Mirjam Weemhoff. "Anatomical Cystocele Recurrence." Obstetrics & Gynecology 127, no. 2 (2016): 341–47. http://dx.doi.org/10.1097/aog.0000000000001272.
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Vergeldt, Tineke F. M., Sander M. J. van Kuijk, Kim J. B. Notten, Kirsten B. Kluivers, and Mirjam Weemhoff. "Anatomical Cystocele Recurrence." Obstetrical & Gynecological Survey 71, no. 5 (2016): 280–81. http://dx.doi.org/10.1097/ogx.0000000000000317.
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Fakhrizal, Edy, Budi Santoso, Eighty Mardiyan Kurniawati, et al. "Platelet-rich plasma as a potential therapy of cystocele: a systematic review and meta-analysis." F1000Research 13 (December 9, 2024): 1508. https://doi.org/10.12688/f1000research.157123.1.
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Abstract Background Platelet-rich plasma (PRP) therapy, is known for its regenerative properties. PRP may be able to help with cystocele cases. This review aims to explore how it might be applied to urogynecological cases, particularly those involving cystocele. Methods The present systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline 2020, Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guideline. The present systematic review was registered with PROSPERO with the registered number CRD42023414366. PubMed, Science Direct, Epistemonikos, COCHRANE, Google Scholar, and ProQuest were among the databases we searched. “(PRP OR Platelet-Rich Plasma) AND (Cystocele OR Anterior Pelvic Organ Prolapse)” from January 2007 to December 2022. Based on the PICO framework (Population = Patients with Cystocele; Intervention = Reconstruction with platelet-rich plasma injection; Compare = Reconstruction only; Outcome: Recurrency of Cystocele), four investigators (AMS, PMA, EAU, RSD, and AH) independently assessed eligibility by titles and abstracts. Using the Joanna Briggs Institute Critical Appraisal tool, each author evaluated full-text articles based on the kind of articles they had received. When consensus could not be obtained, disagreements were settled by involving the supervisors (EF, EMK, and BS). Results A total of 8,924 studies were identified. After removing duplicates and applying eligibility criteria, two articles were included, encompassing 65 patients. In two studies, PRP injections were found and administered post-anterior colporrhaphy at the pubovesical fascia. According to these two trials, women who had anterior colporrhaphy and PRP injections required fewer reoperations. Conclusion PRP has the potential to be a good alternative treatment to prevent cystocele recurrence. However, it cannot be generalized to large populations due to the small number of findings. Further studies with large samples examining the efficacy and safety of the therapy are needed to prove it.
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Dubinskaya, E. D., A. S. Gasparov, I. A. Babicheva, and S. N. Kolesnikova. "Role of pectopexy in cystocele correction." Voprosy ginekologii, akušerstva i perinatologii 21, no. 4 (2022): 53–59. http://dx.doi.org/10.20953/1726-1678-2022-4-53-59.
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Objective. To study and compare the long-term outcomes of surgical correction of cystocele with and without correction of apical prolapse by pectopexy. Design. A prospective study. Patients and methods. A total of 60 patients with cystocele stage 2 or more and apical prolapse stage 1 according to POP-Q (Pelvic Organ Prolapse Quantification System) were examined; 30 patients underwent classical anterior colpoperineorrhaphy and other 30 – combined surgeries, including anterior colporrhaphy and pectopexy. The long-term outcomes of treatment were assessed after 24 months. De novo prolapse stage 2 or more according to POP-Q was considered as prolapse recurrence. Results. The use of pectopexy in the complex surgical treatment of anterior vaginal wall prolapse combined with early stages of apical prolapse (which is not the leading point of prolapse) significantly improved long-term outcomes: 24 months after surgical treatment, cystocele stage 1 was registered only in 13.3% of cases, and 93.3% of patients had no apical prolapse. In the group of patients without pectopexy, progression of apical prolapse to stage 2 was observed in 50% of patients after 24 months. Conclusion. When planning the surgical correction of cystocele, the presence or absence of “hidden” early defects of apical support should be considered. Pectopexy in the correction of apical prolapse combined with cystocele is effective, safe, and pathogenetically sound. Its use improves the long-term outcomes of cystocele treatment and reduces the probability of recurrence. Key words: apical prolapse, long-term treatment outcomes, anterior vaginal wall prolapse, pectopexy, surgical correction, cystocele
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Fakhrizal, Edy, Budi Santoso, Eighty M. Kurniawati, and Fedik A. Rantam. "Impact of Intra-fascial Platelet-Rich Plasma Injection on PDGF Expression, UDI and POP-Q Scores, and Recurrence Risk in Cystocele Patients: A Randomised Controlled Trial." F1000Research 14 (May 12, 2025): 491. https://doi.org/10.12688/f1000research.163906.1.
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Background Cystocele, a form of anterior vaginal wall prolapse, remains one of the most prevalent types of pelvic organ prolapse in women, often associated with a high risk of recurrence following surgical repair. Despite advancements in surgical techniques, the failure rate remains significant, prompting the need for adjunct therapies to enhance healing. Platelet-Rich Plasma (PRP), an autologous blood derivative rich in growth factors, has emerged as a promising regenerative therapy known to accelerate wound healing and tissue regeneration. This study aimed to evaluate the effects of intra-fascial PRP injection during cystocele repair on systemic Platelet-Derived Growth Factor (PDGF) expression, anatomical improvement based on Pelvic Organ Prolapse Quantification (POP-Q) values, symptom severity assessed by the Urinary Distress Inventory (UDI) score, and recurrence risk. Methods A randomized controlled trial was conducted involving 44 women aged 44 to 72 years diagnosed with stage III–IV cystocele. Participants were randomly assigned to two groups: 21 underwent standard cystocele repair (control group), and 23 received the same procedure with a single 10 ml autologous PRP injection into the pubocervical fascia (PRP group). The study was conducted at RSUD Arifin Achmad Pekanbaru from March to October 2024. Blinding was applied to patients, caregivers, and assessors. PDGF levels were measured on days 0, 3, 28, and 90 postoperatively. POP-Q values and UDI scores were assessed at the same intervals. Results PRP administration significantly increased PDGF levels and improved UDI scores on days 28 and 90. Anatomical improvement was also greater in the PRP group. While recurrence rates did not differ significantly, the PRP group had fewer recurrences. Conclusions Intra-fascial PRP injection during cystocele repair improves PDGF expression, healing response, and patient-reported outcomes. Though recurrence risk was not significantly reduced, findings support further trials to assess PRP’s long-term benefits in pelvic reconstructive surgery.
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Orazov, Mekan R., Vyacheslav N. Lokshin, Yulia I. Ruzimatova, and Anastasia E. Pavlova. "Efficacy of surgical treatment of patients with symptomatic cystocele." Clinical review for general practice 5, no. 6 (2024): 57–62. http://dx.doi.org/10.47407/kr2024.5.7.00p421.
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Pelvic organ prolapse is a problem with no ideal solution. Unfortunately, there is still no unified opinion about etiopathogenesis of genital prolapses in general and cystocele in particular. The aim of the study is to increase the effectiveness of surgical treatment in patients with symptomatic cystocele, by double plication of the pubocervical fascia. Materials and methods. The study included 112 patients with symptomatic cystocele of grade II–IV according to POP-Q system, who underwent different variants of surgical treatment method: I – comparison group (n=60) – traditional anterior colporrhaphy; II – the main group (n=52) by the method of double plication of pubocervical fascia. The average age of the patients of the studied cohort was 53.2±9.6 years. The duration of follow-up after surgical treatment was 12 months. The frequency of intra- and postoperative complications, as well as anatomical (recurrence rate) and functional (levelling of cystocele symptoms) treatment results were evaluated. Study. Patients in the study cohort did not differ in age, anthropometric data, social status and clinical characteristics of the underlying disease (p≥0.05). Analysis of early postoperative complications, as well as anatomical and functional results of treatment demonstrated statistically significant advantages of surgical correction of cystocele by double plication of the pubocervical fascia, compared to traditional anterior colporrhaphy (p<0.05). Conclusions. Double pleating of the pubocervical fascia appears to be an effective and safe surgical technique for the treatment of patients with symptomatic cystocele: it significantly (p<0.05) improves anatomical and functional outcomes of treatment and 2.5 times reduces the recurrence rate during 12 months of follow-up, compared to traditional anterior colporrhaphy.
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Dietz, H. P., K. J. Hankins, and V. Wong. "The natural history of cystocele recurrence." International Urogynecology Journal 25, no. 8 (2014): 1053–57. http://dx.doi.org/10.1007/s00192-014-2339-4.
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Pirtea, Marilena, Ligia Bălulescu, Laurentiu Pirtea, et al. "The Effectiveness of Mesh-Less Pectopexy in the Treatment of Vaginal Apical Prolapse—A Prospective Study." Diagnostics 15, no. 5 (2025): 526. https://doi.org/10.3390/diagnostics15050526.
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Objectives: Pelvic organ prolapse (POP) is a common condition affecting women, often requiring surgical intervention. Laparoscopic pectopexy has gained popularity, but there is ongoing debate about the efficacy and safety of mesh versus thread as fixation materials. This study aims to compare the outcomes of these two techniques, focusing on cure, recurrence and postoperative complication rates. Methods: A prospective analysis was conducted on patients undergoing laparoscopic pectopexy for POP. This prospective study included 78 patients diagnosed with pelvic organ prolapse stage II–IV according to the POP-Q system. Thirty-six (46.15%) underwent laparoscopic pectopexy with mesh and forty-two patients (53.84%) underwent the laparoscopic pectopexy procedure with thread. Data on cure rates, recurrence, mild asymptomatic cystocele and chronic pain were analyzed. Statistical significance was assessed using chi-squared and Fisher’s exact tests. Results: The cure rate was high in both group: 94.4% in the Mesh group and 100% in the thread group. Recurrence of vaginal apex prolapse occurred in 5.56% of the Mesh group, while no recurrence was observed in the thread group. Chronic pain was reported in 11.11% of the Mesh group but was absent in the thread group (p < 0.05). The overall rate for cystocele across all participants was 44.87% (40.48% of patients in the thread group experienced mild asymptomatic cystocele, compared to 50% in the Mesh group). No intraoperative complications were reported in either group. Conclusions: Thread-based laparoscopic pectopexy demonstrates equivalent or superior outcomes compared to mesh, with a high cure rate, no recurrence rate and no chronic pain. These findings support the use of thread as a safer alternative, aligning with FDA guidelines on mesh usage.
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Bandiera, S., G. Raciti, A. Aloisi, et al. "DOUBLE TRANSOBTURATOR APPROACH TO TREATING CYSTOCELE." Urogynaecologia 22, no. 3 (2010): 17. http://dx.doi.org/10.4081/uij.2008.3.17.
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The aim of this study is to show the safety and efficacy of the double transobturator approach, a new technique for anterior vaginal wall prolapse, using several different kinds of meshes (synthetic and biological).This is a retrospective study of 74 women treated between 2005 and 2007. The patients underwent a 3, 6 and 12 month follow-up. The anatomical cure rate, defined as grade of prolapse &lt;2, was 79.7%. Fifteen patients had a recurrence, 12 were treated with biological VS meshes and 3 were treated with synthetic meshes. Vaginal erosion was reported in 5 (6.7%) of these patients, two of whom were treated with topic estrogenic therapy, and three of whom with partial excision. These results suggest that this technique is safe and efficacious and that the best meshes to use are synthetic meshes, because they have a lower recurrence rate than biological meshes.
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Fünfgeld, Christian, Margit Stehle, Brigit Henne, et al. "Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months." Geburtshilfe und Frauenheilkunde 77, no. 09 (2017): 993–1001. http://dx.doi.org/10.1055/s-0043-116857.
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Abstract Introduction Pelvic organ prolapse can significantly reduce quality of life of affected women, with many cases requiring corrective surgery. The rate of recurrence is relatively high after conventional prolapse surgery. In recent years, alloplastic meshes have increasingly been implanted to stabilize the pelvic floor, which has led to considerable improvement of anatomical results. But the potential for mesh-induced risks has led to a controversial discussion on the use of surgical meshes in urogynecology. The impact of cystocele correction and implantation of an alloplastic mesh on patientsʼ quality of life/sexuality and the long-term stability of this approach were investigated. Method In a large prospective multicenter study, 289 patients with symptomatic cystocele underwent surgery with implantation of a titanized polypropylene mesh (TiLOOP® Total 6, pfm medical ag) and followed up for 36 months. Both primary procedures and procedures for recurrence were included in the study. Anatomical outcomes were quantified using the POP-Q system. Quality of life including sexuality were assessed using the German version of the validated P-QoL questionnaire. All adverse events were assessed by an independent clinical event committee. Results Mean patient age was 67 ± 8 years. Quality of life improved significantly over the course of the study in all investigated areas, including sexuality and personal relationships (p < 0.001, Wilcoxon test). The number of adverse events which occurred in the period between 12 and 36 months after surgery was low, with just 22 events reported. The recurrence rate for the anterior compartment was 4.5%. Previous or concomitant hysterectomy increased the risk of recurrence in the posterior compartment 2.8-fold and increased the risk of erosion 2.25-fold. Conclusion Cystocele correction using a 2nd generation alloplastic mesh achieved good anatomical and functional results in cases requiring stabilization of the pelvic floor and in patients with recurrence. The rate of recurrence was low, the patientsʼ quality of life improved significantly, and the risks were acceptable.
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Dietz, H. P., V. Chantarasorn, and K. L. Shek. "Levator avulsion is a risk factor for cystocele recurrence." Ultrasound in Obstetrics and Gynecology 36, no. 1 (2010): 76–80. http://dx.doi.org/10.1002/uog.7678.
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Sacarin, Geanina, Ahmed Abu-Awwad, Nitu Razvan, et al. "Prospective Comparative Study of EMSella Therapy and Surgical Anterior Colporrhaphy for Urinary Incontinence: Outcomes and Efficacy." Healthcare 13, no. 8 (2025): 864. https://doi.org/10.3390/healthcare13080864.
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Background: This prospective comparative study investigates urinary incontinence (UI), often associated with grade 2 cystocele, a condition that poses significant physical, emotional, and social challenges for affected women. While anterior colporrhaphy remains the gold standard for anatomical correction, non-invasive alternatives such as EMSella therapy have gained increasing attention. The study compares the outcomes of these two distinct approaches in managing UI and the associated pelvic organ prolapse. Materials and Methods: This study involved 133 menopausal women with grade 2 cystocele and UI, including 78 treated with anterior colporrhaphy and 55 with EMSella therapy, across two Romanian healthcare centers. Outcomes were assessed through prolapse reduction (POP-Q), bladder function normalization, recurrence rates, quality of life (PFDI-20, PFIQ-7), patient satisfaction, complication rates, recovery times, and social or professional disruptions. Results: Anterior colporrhaphy was more effective in anatomical correction (88% vs. 64% achieving stage 0 prolapse) and bladder function normalization (72% vs. 55%, p = 0.04), with lower one-year recurrence rates (14% vs. 31%, p = 0.03). EMSella therapy allowed faster recovery, with 91% resuming daily activities within a week. Both groups showed improvement in quality of life, but reductions in PFDI-20 and PFIQ-7 scores were more significant after surgery. EMSella had fewer infections and no dyspareunia, reflecting a better safety profile. Conclusions: EMSella therapy and anterior colporrhaphy significantly benefit managing UI associated with grade 2 cystocele. While anterior colporrhaphy provides definitive anatomical correction and superior long-term outcomes, EMSella therapy represents a safer, less invasive alternative with rapid recovery, making it ideal for patients with mild conditions or surgical contraindications. Treatment should be tailored to individual patient needs and preferences.
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Taranov, V. V. "Comparative analysis of laparoscopic techniques for correction of apical prolapse." Practical medicine 23, no. 2 (2025): 146–51. https://doi.org/10.32000/2072-1757-2025-2-146-151.
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The variety of options for reconstructive correction of genital prolapse demonstrates the lack of a universal treatment method and the urgency of searching for the most advanced options in order to reduce the risk of recurrence and complications. The purpose — comparative evaluation of the results of surgical treatment of genital prolapse using laparoscopic lateral fixation and pectopexy. Material and methods. A comparative analysis of the results of treatment of apical and antero-apical genital prolapse using laparoscopic access was performed. The first group consisted of patients who underwent lateral fixation (n = 20), the second group included patients who underwent pectopexy (n = 20). Results. As a result of 1 year of follow-up in the postoperative period, it was noted that both techniques were associated with a significant improvement in quality of life (the sum of PFDI scores before surgery in group 1 was 122.1, after 12 months 11.5; in the second group 117.5 and 12.2, respectively). At the same time, recurrence of apical prolapse was rare (not more than 5% in both groups), whereas cystocele of stage 2 or more 12 months after surgery was more frequent among patients of the second group (5% in the first group and 15% in the second group). Conclusion. Laparoscopic lateral fixation and pectopexy make it possible to correct the apical defect with minimal risk of recurrence. In the presence of concomitant cystocele, lateral hysteropexy is preferable.
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Wong, Vivien, Ka Lai Shek, Judith Goh, Hannah Krause, Andrew Martin, and Hans Peter Dietz. "Cystocele recurrence after anterior colporrhaphy with and without mesh use." European Journal of Obstetrics & Gynecology and Reproductive Biology 172 (January 2014): 131–35. http://dx.doi.org/10.1016/j.ejogrb.2013.11.001.
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Goldberg, Roger P., Sumana Koduri, Robert W. Lobel, et al. "Protective effect of suburethral slings on postoperative cystocele recurrence after reconstructive pelvic operation." American Journal of Obstetrics and Gynecology 185, no. 6 (2001): 1307–13. http://dx.doi.org/10.1067/mob.2001.119080.
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Wong, V., K. Shek, A. Rane, J. Goh, H. Krause, and H. P. Dietz. "Is levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement?" Ultrasound in Obstetrics & Gynecology 42, no. 2 (2013): 230–34. http://dx.doi.org/10.1002/uog.12433.
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Kamoeva, S. V., D. S. Makovskaya, and Yu E. Dobrokhotova. "Surgical management of female pelvic organ prolapse using titanium "silk" mesh replacement: 5-year results." Russian Journal of Woman and Child Health 7, no. 3 (2024): 227–35. http://dx.doi.org/10.32364/2618-8430-2024-7-3-6.
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Background: pelvic organ prolapse (POP) is a common condition that significantly impairs quality of life and has potentially serious health consequences. Aim: to evaluate the long-term safety and efficacy of using titanium "silk" mesh endoprostheses for the surgical treatment of apical and anterior prolapse in women. Patients and Methods: 103 women with symptomatic POP grade ≥2 were enrolled in this prospective interventional study. Women underwent bilateral sacrospinous and anterior transobturator hysteropexy with implantation of a titanium "silk" mesh endoprosthesis. Early and late postoperative complications and other adverse events were evaluated. Quality of life was assessed with special questionnaires. The women were followed for 5 years postoperatively. Results: the rate of intraoperative complications was insignificant and all adverse events were not associated with the type of implant used. Fistula, tissue granulation, penetration of synthetic material into the urethra and bladder, and other potential complications were not reported during long-term follow-up. Recurrence of cystocele occurred in 3 (3%) women 5 years after surgery. There were no other adverse events reported. Quality of life improved significantly after surgery and remained stable throughout follow-up. The most significant positive changes were observed in the indices of complaints about the sensation of a foreign body in the perineal area, the necessity to reposition the prolapsed genitalia (hernia sac) to urinate. Conclusions: the treatment is characterized by a favorable safety profile and a high level of patient satisfaction, as well as a low recurrence rate. KEYWORDS: mesh, titanium mesh, titanium "silk", pelvic organ prolapse, cystocele, reconstructive surgery. FOR CITATION: Kamoeva S.V., Makovskaya D.S., Dobrokhotova Yu.E. Surgical management of female pelvic organ prolapse using titanium "silk" mesh replacement: 5-year results. Russian Journal of Woman and Child Health. 2024;7(3):227–235 (in Russ.). DOI: 10.32364/2618-8430-2024-7-3-6.
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ORAZOV, M. R., V. E. RADZINSKIY, and F. F. MINNULLINA. "Clinical phenotypes of pelvic organ prolapse: setting priorities." Practical medicine 23, no. 1 (2025): 44–49. https://doi.org/10.32000/2072-1757-2025-1-44-49.
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Pelvic organ prolapse (POP) is a prolapse of the pelvic organs as a result of a weakening of the pelvic floor supporting system. To denote prolapse of the anterior vaginal wall, the term «cystocele» is used, of the posterior wall — «rectocele», while the lowering of the arch / stump of the vagina or cervix is called «apical prolapse». There is also a «total prolapse» — a recurrence of the pathological process with all three sectors involved, and the uterus extending beyond the genital fissure. The genitals involved in the pathological process determine the POP clinical picture; 2/3 of women show signs of two or three sectors involved in the process at the same time. In general, surgical procedures are effective in relieving the POP symptoms, preventing the disease progression and improving quality of life. However, the short- and medium-term results of surgical treatment are not always satisfactory. The recurrence rate of POP after surgical treatment is high, and the need for repeated surgery is approaching 30%. The purpose is to analyze and summarize the current scientific data on the POP clinical phenotypes. We analyzed 2014–2024 scientific publications in the PubMed, eLibrary, CochraneLibrary, and Science Direct databases using the keywords: pelvic organ prolapse, cystocele, rectocele, and apical prolapse. Conclusions. Based on the literature analysis, we conclude that to date there is no understanding of the mechanics of the POP formation in different parts of the pelvis, the interaction of prolapses of the contralateral sections. There is no unified approach among specialists to the treatment of patients with POP, and indications for surgical intervention are not unified. This determines the importance of studying different clinical phenotypes of POP, their relationship and interaction in a large sample.
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Dutt, Ravi, Ram Niwas, Sukhbir Ravish, Usha Yadav, Sujata Jinagal, and Mohit Kumar. "Postpartum Uterine Prolapse and Vaginal Cystocoele in a Murrah Buffalo." Indian Journal of Animal Reproduction 44, no. 1 (2023): 66–68. http://dx.doi.org/10.48165/ijar.2023.44.01.133.
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A pluriparous Murrah buffalo was presented with vaginal tear over fornix vagina along with post-partum prolapse of uterus, cervix and urinary bladder. The case was managed by suturing of vaginal wall after repositioning the prolapsed mass. The catheterization of urinary bladder and modified Buhner's sutures through vulvar lips were applied to prevent the recurrence of the condition.
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Ishchenko, A. I., A. D. Komarova, A. A. Ishchenko, et al. "New surgical technique for the correction of combined form of pelvic organ prolapse." Voprosy ginekologii, akušerstva i perinatologii 23, no. 4 (2024): 132–36. https://doi.org/10.20953/1726-1678-2024-4-132-136.
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This article presents a new surgical technique for the correction of combined form of pelvic organ prolapse (POP) characterized by anterior vaginal wall prolapse (bladder prolapse or cystocele), urethral hypermobility, and stress urinary incontinence in women aged 59–75 years using personalized titanium implants with the original, mesh-ligature-“anchor” transobturator-sacrospinous-prepubic method of fixation. To date, 11 surgeries have been performed using this technique. Conclusion. The developed surgical technique for the correction of combined form of POP improves safety and optimizes the results of surgical treatment, minimizes intraoperative and mesh-related complications, and reduces disease recurrence. Key words: titanium implants, anterior vaginal wall prolapse, combined forms of pelvic organ prolapse, transobturator-sacrospinous-prepubic method of implant fixation
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Chen, Chi-Hau, Wen-Yih Wu, Bor-Ching Sheu, Song-Nan Chow, and Ho-Hsiung Lin. "Comparison of Recurrence Rates after Anterior Colporrhaphy for Cystocele Using Three Different Surgical Techniques." Gynecologic and Obstetric Investigation 63, no. 4 (2007): 214–21. http://dx.doi.org/10.1159/000098116.
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Lin, Ting-Hsuan, Fung-Chao Tu, Ho-Hsiung Lin, and Sheng-Mou Hsiao. "Predictors of Clinical Outcome in Women with Pelvic Organ Prolapse Who Underwent Transvaginal Mesh Reconstruction Surgery." Medicina 58, no. 2 (2022): 148. http://dx.doi.org/10.3390/medicina58020148.
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Background and Objectives: To identify the predictors of clinical outcomes in women with pelvic organ prolapse (POP) who underwent transvaginal reconstruction surgery, especially with transobturator mesh fixation or sacrospinous mesh fixation. Materials and Methods: All women with POP who underwent transvaginal reconstruction surgery, especially with transobturator mesh fixation or sacrospinous mesh fixation, were reviewed. Results: Between January 2011 and May 2019, a total of 206 consecutive women were reviewed, including 68 women receiving POP reconstruction with transobturator mesh fixation and 138 women who underwent POP reconstruction with sacrospinous mesh fixation. The least experienced surgeon (hazard ratio = 804.6) and advanced stage of cystocele (hazard ratio = 8.80) were the predictors of POP recurrence, especially those women with stage 4 of cystocele. Young age (hazard ratio = 0.94) was a predictor for mesh extrusion, especially those women with age ≤67 years. Follow-up interval (odds ratio = 1.03, p = 0.02) was also an independent predictor of mesh extrusion. High maximum flow rate (Qmax, hazard ratio = 1.03) was the sole predictor of postoperative stress urinary incontinence, especially those women with Qmax ≥19.2 mL/s. Preoperative overactive bladder syndrome (hazard ratio = 3.22) were a predictor for postoperative overactive bladder syndrome. In addition, overactive bladder syndrome rate improved after surgery in the sacrospinous group (p = 0.0001). Voiding dysfunction rates improved after surgery in both sacrospinous and transobturator groups. Conclusions: Predictors of clinical outcome in women who underwent transvaginal POP mesh reconstruction are identified. The findings can serve as a guide for preoperative consultation of similar procedures.
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Cadenbach-Blome, Tina, Markus Grebe, Mathias Mengel, Friedrich Pauli, Angelika Greser, and Christian Fünfgeld. "Significant Improvement in Quality of Life, Positive Effect on Sexuality, Lasting Reconstructive Result and Low Rate of Complications Following Cystocele Correction Using a Lightweight, Large-Pore, Titanised Polypropylene Mesh." Geburtshilfe und Frauenheilkunde 79, no. 09 (2019): 959–68. http://dx.doi.org/10.1055/a-0984-6614.
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Abstract Introduction Patients who suffer from pelvic organ prolapse can experience severe limitations in their quality of life. To improve the quality of life of women affected and achieve a stable reconstruction, surgical therapy is often indispensable. In conventional prolapse surgery, the rate of recurrence is high. For this reason, alloplastic mesh has been implanted increasingly in recent years to reconstruct the anatomy of the pelvic floor organs. Even if the anatomical result can be significantly improved as a result, the mesh-induced complications have been the subject of controversial discussion. In this national, multicentre study, the quality of life, anatomical result as well as the rate of complications following the implantation of an alloplastic mesh for the correction of a cystocele were investigated. Method Fifty-four patients with symptomatic ≥ grade II were included in this prospective, national, multicentre study. The study participants were implanted with a titanised polypropylene mesh (TiLOOP® PRO A, pfm medical ag). The follow-up observation period was 12 months. Primary as well as repeat procedures were taken into account. The anatomic result of the pelvic floor reconstruction was quantified using the POP-Q system. Data on quality of life and sexuality were collected using validated questionnaires. All complications which occurred were documented and evaluated by an independent committee. Results On average, the patients were in line with the census. An improvement in quality of life was able to be determined during the study in all domains investigated (p < 0.001, Wilcoxon test). Minus incorrect entries and incorrect reports, a total of 19 reports of adverse events in 15 patients were evaluated by the end of the study. The rate of recurrence in the anterior compartment was 4.3%. Conclusion In the reconstruction of the anatomical position of the pelvic floor organs given the presence of a symptomatic cystocele, the implantation of a third-generation alloplastic mesh achieves very good results. Affected patients benefit from the anatomical stability as well as a significant improvement in quality of life, whereby the risks are justifiable.
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Kakou, Charles, Roland Adjoby, Raoul Kasse, Victorine Assuikwe, Boston Mian, and Serge Boni. "Genital prolapse at university hospital of Cocody: clinical aspects and therapeutic management." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 5 (2018): 1673. http://dx.doi.org/10.18203/2320-1770.ijrcog20181893.
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Background: To determine the epidemiological aspects of genital prolapse; to describe the different clinical aspects of genital prolapse observed and to evaluate the therapeutic management of genital prolapse at the University hospital of Cocody (UH-C).Methods: We did an observational and transversal study with a descriptive purpose over 5 years from 2012 to 2016 in the Gynecology and obstetrics department of UH-C. The studied population was all cases of genital prolapse diagnosed and treated in the service during the period of the study. A follow-up over one year after surgery has been observed to evaluate surgical outcomes and recurrences. Genital prolapse was generally a uterine prolapse at stage 3 or 4. It was associated to cystocele in 31.4%. We did not find stress urinary incontinence associated with prolapse in our study. The surgical intervention performed was, in the majority case, the triple perineal intervention with success of 95.6%. A case of recurrence in the form of cystocele has been observed to a year of decline.Results: Genital prolapse was relatively common. It accounted for 0.5% of all gynecological visits. Women were young with an average age of 39.5 years. 62.9% were multiparous. 62.5% had given birth at least once at home without medical assistance. The reason for consultation the most watched was the projection of body at the vulva.Conclusions: Genital prolapse is a condition under estimated in Côte d'Ivoire. It represented 0.5% of the gynecological visits. Obstetric traumas were frequently found in our young patients with genital prolapse. The sociocultural considerations have contributed to delay consultations, to observe very advanced stages. The surgery performed was mainly the perineal triple surgery.
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Galan, Louis-Edouard, Stéphanie Bartolo, Céline De Graer, Sophie Delplanque, Marine Lallemant, and Michel Cosson. "Comparison of Early Postoperative Outcomes for Vaginal Anterior Sacrospinous Ligament Fixation with or without Transvaginal Mesh Insertion." Journal of Clinical Medicine 12, no. 11 (2023): 3667. http://dx.doi.org/10.3390/jcm12113667.
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Pelvic organ prolapse affects one in three women, and cystocele accounts for 80% of the indications for surgery. Following the withdrawal of transvaginal mesh from the market, the objective of the present before-and-after study was to compare of the previous reference technique (UpholdTM (Boston Scientific, Marlborough, MA, USA) mesh insertion) with anterior sacrospinous ligament fixation with suturing in terms of the outcomes 2 months after surgery. We performed a retrospective, observational, before-and-after study at Lille University Medical Center (Lille, France) by including consecutive patients operated on between 2011 and 2018 for UpholdTM mesh insertion and between 2018 to 2020 for anterior sacrospinous ligament fixation. The primary outcome was the early recurrence of prolapse, and the secondary outcomes were the occurrence of early per-operative or post-operative complications and the development of de novo stress urinary incontinence. Here, 466 patients were included in the study (382 in the UpholdTM group and 84 in the anterior sacrospinous ligament fixation group). The failure rate at 2 months was 6.0% (5 out of 84) for anterior sacrospinous ligament fixation and 1.3% (5 out of 382) for UpholdTM (p < 0.01). The prevalence of acute urinary retention was significantly lower in the anterior sacrospinous ligament fixation group (3.6%) than in the UpholdTM group (14.1%; p < 0.01), as was the de novo stress urinary incontinence rate (11.9% vs. 33.8%, respectively; p < 0.01). Anterior sacrospinous ligament fixation appears to be an effective, safe alternative to mesh insertion in the management of cystocele via the vaginal approach; the early complication rate was slightly lower, but the early failure rate was slightly higher.