Transvaginal surgical treatment of stage III-IV cystocele using a light prolene mesh: Safety of use and 5-year follow-up results.

Abstract

The relevance of the article is due to the spread of the problem of genital prolapse in women. In order to solve this, the purpose of the presented work is to present and evaluate the 5-year experience of using light-weight polypropylene mesh, which is used in the transvaginal surgical treatment of stage III-IV cystocele. A retrospective cohort study was conducted at the Dnipro State Medical University at the Department of Obstetrics and Gynecology in the period from 2010 to 2020. A total of 612 patients with an average age of 64.8 ± 8.2 years (range 47-79) were included in it. Long-term analysis of operative treatment in 374 patients (76.0%) after 60 months showed a high level of satisfaction with the results of the operation 99.2% (371/374). A significant level of elimination of pathological symptoms in the functioning of the pelvic organs and improvement of the quality of life was established, which were assessed using questionnaires: PFDI-20 (76.4-4.3 (p < 0.05)), PFIQ-7 (41-8.4 (p < 0.05)), before the operation and at the final stage of the study. In total, 12 months after the operation, 2.6% (12/467) of the patients were re-operated on due to erosion of the vaginal wall at the site of placement of the MESH-system. The proposed technique for restoring the front wall of the vagina in case of an isolated cystocele of the III-IV degree, without signs of incomplete or complete prolapse of the uterus, showed a recurrence-free result in the indicated segment of the vagina.