Reconstruction of Pelvic-Organ Prolapse Using a Self-Fashioned Gynemesh

Abstract

Objective: This study was conducted to evaluate the effectiveness of self-fashioned Gynemesh for the concomitant treatment of pelvic-organ prolapse (POP) and the factors involved in mesh erosion and disease recurrence. Design: This was a retrospective analysis of the results of surgery using Gynemesh for surgical management of POP. Population: The study population consisted of 81 women with stage 2 or higher POP, according to International Continence Society POP (ICS POP-Q) criteria, who underwent vaginal surgery in which Gynemesh was used. Methods: This was a retrospective study of surgeries conducted over a period of 16 months. Surgery involved a vaginal approach with mesh reinforcement. At 12 or more months postsurgery, women were examined for prolapse recurrence and were given visual analogue scale testing for satisfaction with the surgical outcome. Women completed quality-of-life (QOL) questionnaires preoperatively and at 12 months postsurgery. Objective success of surgery was assessed at 12 months postsurgery. Secondary outcomes were subjective success, complications, QoL outcomes, and patients' satisfaction. Results: Objective and subjective success rates were 91.4 and 92.6% at 12 months, respectively. Seven women developed further objective (ICS POP-Q stage 2 or more) POP. New prolapse in nonrepaired compartments accounted for 5 of 7 (71.4%) failures at 12 months. Five mesh exposures required further surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 24% at 12 months. QoL scores were significantly improved at 12 months, compared with baseline (p < 0.001). Conclusions: Modified pelvic-floor reconstruction using self-fashioned Gynemesh is a practical procedure for various kinds of POP. However, the long-term effect remains unknown. (J GYNECOL SURG 27:71)