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The treatment of anterior vaginal wall prolapsed by repair with mesh versus colporrhaphy

  • Urology - Review
  • Published:
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Abstract

Purpose

To compare patient outcomes of mesh repair and colporrhaphy for the treatment of anterior vaginal wall prolapse (AVP).

Materials and methods

We searched PubMed®, Embase®, and Cochrane Library databases to identify the included studies. The outcome measures included anatomical success, patient satisfaction, patient sexual function, perioperative data, and complications. Statistical analyses were performed using Cochrane Collaboration Review Manager software (RevMan 5.1.4).

Results

The study inclusion criteria were met by 11 articles involving 1455 patients. Synthesized data indicated that mesh surgery was more complex than colporrhaphy with regard to perioperative condition [mean difference (MD) 0.28, 95 % confidence interval (CI) 0.07–0.49, p = 0.010]. There were no significant differences for the following complications: urinary retention [relative risk (RR) 1.12, 95 % CI 0.65–1.94, p = 0.68], urinary incontinence (RR 1.01, 95 % CI 0.63–1.63, p = 0.96), voiding difficulty (RR 1.11, 95 % CI 0.69–1.80, p = 0.66), dyspareunia (RR 1.21, 95 % CI 0.87–1.67, p = 0.26), urinary tract infection (RR 1.15, 95 % CI 0.74–1.78, p = 0.53), and vaginal bulge (RR 1.08, 95 % CI 0.93–1.25, p = 0.32). There were instances of more serious complications in group 1, i.e., the mesh group. However, AVP cure rate was significantly higher in the mesh group (RR 1.44, 95 % CI 1.34–1.55, p < 0.00001). The cure rate was not significantly dependent on patient satisfaction (RR 1.10, 95 % CI 0.96–1.26, p = 0.16) or postoperative sexual function (RR 1.03, 95 % CI 0.90–1.11, p = 0.71).

Conclusions

Surgical repair with the mesh procedure appears to be a better choice for the treatment of anterior vaginal wall prolapse.

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Abbreviations

RCT:

Randomized controlled trial

POP:

Pelvic organ prolapse

AVP:

Anterior vaginal wall prolapsed

RR:

Relative risk

CI:

Confidence interval

References

  1. Jelovsek JE, Maher C, Barber MD (2007) Pelvic organ prolapsed. Lancet 369:1027–1038

    Article  PubMed  Google Scholar 

  2. Jackson S, Smith P (1997) Fortnightly review: diagnosing and managing genitourinary prolapse. Br Med J 314:875–877

    Article  CAS  Google Scholar 

  3. Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1304

    Article  PubMed  CAS  Google Scholar 

  4. Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ, Goldberg R (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1362

    Article  PubMed  CAS  Google Scholar 

  5. Carey M, Higgs P, Goh J, Lim J, Leong A, Krause H, Cornish A (2009) Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial. Br J Obstet Gynaecol 116:1380–1386

    Article  CAS  Google Scholar 

  6. Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA (1994) Health-related quality of life measures for women with urinary incontinence: the incontinence impact questionnaire and the urogenital distress inventory. Qual Life Res 3:291–306

    Article  PubMed  CAS  Google Scholar 

  7. Van der Vaart CH, de Leeuw JR, Roovers JP, Peter A, Heintz M (2003) Measuring health-related quality of life in women with urogenital dysfunction: the urogenital distress inventory and incontinence impact questionnaire revisited. Neurourol Urodyn 22:97–104

    Article  PubMed  Google Scholar 

  8. Higgins JPT, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.4 (updated March 2011). The Cochrane Collaboration. Available at www.cochrane-handbook.org. Accessed 27 Feb 2012

  9. Moher D, Liberati A, Tetzlaff J (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Br Med J 339:b2535

    Article  Google Scholar 

  10. Vollebregt A, Fischer K, Gietelink D, van der Vaart CH (2012) Effects of vaginal prolapse surgery on sexuality in women and men; results from a RCT on repair with and without mesh. J Sex Med 9:1200–1211

    Article  PubMed  Google Scholar 

  11. Altman D, Vayrynen T, Engh ME, Axelsen S, Falcone C (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364:1826–1836

    Article  PubMed  CAS  Google Scholar 

  12. Cao Q, Chen Y-S, Ding J-X, Hu CD, Feng W-W, Hu W-G, Hua K-Q (2013) Long-term treatment outcomes of transvaginal mesh surgery versus anterior–posterior colporrhaphy for pelvic organ prolapse. Aust N Z J Obstet Gynaecol 53:79–85

    Article  PubMed  Google Scholar 

  13. Delroy CA, Castro RDA, Dias MM, Feldner PC Jr, Bortolini MAT, Girão MJ, Sartori MG (2013) The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial. Int Urogynecol J 24:1899–1907

    Article  PubMed  PubMed Central  Google Scholar 

  14. Dias MM, Castro RDA, Bortolini MAT, Delroy CA, Martins PCF, Girão MJ, Sartori MG (2015) Two-years results of native tissue versus vaginal mesh repair in the treatment of anterior prolapse according to different success criteria: a randomized controlled trial. Neurourol Urodyn 2015

  15. Tamanini JTN, Castro RCDOS, Tamanini JM, Castro RA, Sartori MGF, Girão MJBC (2015) A prospective, randomized, controlled trial of the treatment of anterior vaginal wall prolapse: medium term followup. J Urol 193(4):1298–1304

    Article  PubMed  Google Scholar 

  16. El-Nazer MA, Gomaa IA, Ismail WA, Swidan KH, El-Etriby MA (2012) Anterior colporrhaphy versus repair with mesh for anterior vaginal wall prolapse: a comparative clinical study. Arch Gynecol Obstet 286:965–972

    Article  PubMed  CAS  Google Scholar 

  17. Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, Heinonen PK (2012) Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. Am J Obstet Gynecol 203:235–242

    Google Scholar 

  18. Rudnicki M, Laurikainen E, Pogosean R, Kinne I, Jakobsson U, Teleman P (2014) Anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. Br J Obstet Gynaecol 121:102–111

    Article  CAS  Google Scholar 

  19. Tamanini JTN, Castro RCDOS, Tamanini JM, Milhomem J, Feldner PC Jr, Castro RDA, Sartori MGF, Girão MJBC (2013) Treatment of anterior vaginal wall prolapse with and without polypropylene mesh: a prospective, randomized and controlled trial—part II. Int Braz J Urol 39(4):531–541

    Article  PubMed  Google Scholar 

  20. Vollebregt A, Fischer K, Gietelink D, van der Vaart CH (2012) Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh. Urogynaecology 119:1518–1527

    Google Scholar 

  21. Mariëlla I, Milani AL, den Boon J, Vervest HA, Vierhout ME (2011) Trocar-guided mesh compared with conventional vaginal repair in recurrent prolapse: a randomized controlled trial. Obstet Gynecol 117:1436–1444

    Article  Google Scholar 

  22. Nichols DH, Randall CH (1983) Repair of genital fistulae in vaginal surgery. Williams & Wilkins, Baltimore, pp 308–316

    Google Scholar 

  23. Paraiso MF, Menefee S, Schaffer J (2008) Investigation of surgical procedures for pelvic organ prolapse—the mesh dilemma. J Minim Invasive Gynecol 15:521–526

    Article  PubMed  Google Scholar 

  24. Deffieux X, de Tayrac R, Huel C, Bottero J, Gervaise A, Bonnet K (2007) Vaginal mesh erosion after transvaginal repair of cystocele using Gynemesh or Gynemesh-Soft in 138 women: a comparative study. Int Urogynecol J Pelvic Floor Dysfunct 18:73–79

    Article  PubMed  CAS  Google Scholar 

  25. Abed H, Rahn DD, Lowenstein L, Balk EM, Clemons JL, Rogers RG (2011) Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Int Urogynecol J 22:789–798

    Article  PubMed  Google Scholar 

  26. Skala CE, Renezeder K, Albrich S, Puhl A, Laterza RM, Naumann G, Koelbl H (2011) Mesh complications following prolapse surgery: management and outcome. Eur J Obstet Gynecol Reprod Biol 159:453–456

    Article  PubMed  Google Scholar 

  27. U.S. Food and Drug Administration. FDA safety communication: UPDATE on serious complications associated with transvaginal placement of surgical mesh for pelvic organ prolapse. Available at http://www.fda.gov/downloads/MedicalDevices/Safety/AlertsandNotices/UCM262760.pdf. Accessed 07 July 2014

  28. Deng T, Liao B, Luo D, Shen H, Wang K (2015) Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta-analysis. BJU international. Wiley www.bjui.org

  29. Keys T, Campeau L, Badlani G (2012) Synthetic mesh in the surgical repair of pelvic organ prolapse: current status and future directions. Urology 80:237–243

    Article  PubMed  Google Scholar 

  30. Gauruder-Burmester A, Koutouzidou P, Rohne J, Gronewold M, Tunn R (2007) Follow-up after polypropylene mesh repair of anterior and posterior compartments in patients with recurrent prolapse. Int Urogynecol J Pelvic Floor Dysfunct 18:1059–1064

    Article  PubMed  CAS  Google Scholar 

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Funding

This study was supported by the Prostate Cancer Foundation Young Investigator Award 2013, the National Natural Science Foundation of China (Grant No. 81300627); the National Science Foundation for Young Scholars of China (Grant No. 81300579); and Pillar Program from Science and Technology Department of Sichuan Province (Grant No. 2014JY0219).

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    Authors and Affiliations

    1. Department of Urology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People’s Republic of China

      Yi Sun, Cai Tang, Deyi Luo, Lu Yang & Hong Shen

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    1. Yi Sun
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    2. Cai Tang
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    3. Deyi Luo
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    4. Lu Yang
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    5. Hong Shen
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    Correspondence to Hong Shen.

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    The authors have no conflicts to disclose.

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    Yi Sun and Cai Tang contributed equally to this work and are the co-first authors.

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    Sun, Y., Tang, C., Luo, D. et al. The treatment of anterior vaginal wall prolapsed by repair with mesh versus colporrhaphy. Int Urol Nephrol 48, 155–167 (2016). https://doi.org/10.1007/s11255-015-1179-6

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    • DOI: https://doi.org/10.1007/s11255-015-1179-6

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