Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse

Jason P. Gilleran, Philippe Zimmern

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective To report the short- and intermediate- term outcome of safety and efficacy after abdominal-mesh sacrocolpopexy (MSC) for recurrent anterior, posterior and vault ('triple-compartment') pelvic organ prolapse (POP). Patients and methods In a database review we identified non-neurogenic women who had MSC for recurrent triple-compartment POP and with a ≥6-month cystographic follow-up. The preoperative evaluation included a history, physical examination, Urogenital Distress Inventory (UDI-6) and visual analogue quality-of-life (QoL) questionnaires, urodynamic studies, and a standing lateral voiding cysto-urethrogram (VCUG) with rest-strain views. All surgery as performed by the same surgeon, using polypropylene (Marlex) mesh. Perioperative data, the VCUG at 6 months, and interval pelvic examinations were recorded. RESULTS Between 2000 and 2006, 29 postmenopausal women (Caucasian, mean age 64 years, sd 11) underwent MSC. The mean (sd, range) operative duration was 228 (75, 170-340) min, the estimated blood loss 150 (100) mL and the inpatient stay 3 (1) days. At a mean (sd) follow-up of 23 (16) months, the physical examination showed no evidence of POP of grade ≥2, with mean POP-Quantification scores of -2.8 (0.4), -2.9 (0.4) and -9.3 (0.8) for points A a, A p and C, respectively. Two patients (8%) had evidence of grade ≥2 cystocele at the 6-month VCUG. After MSC, four of the six UDI and the QoL scores were significantly lower at the last follow-up than at baseline, with no change in sexual or defecatory function. CONCLUSIONS The Objective and subjective improvement at the short and intermediate follow-up after MSC suggest that this is a safe and effective treatment for recurrent triple-compartment POP.

Original languageEnglish (US)
Pages (from-to)1090-1094
Number of pages5
JournalBJU International
Volume103
Issue number8
DOIs
StatePublished - Apr 2009

Fingerprint

Pelvic Organ Prolapse
Physical Examination
Quality of Life
Cystocele
Gynecological Examination
Polypropylenes
Urodynamics
Inpatients
History
Databases
Safety
Equipment and Supplies

Keywords

  • Cystocele
  • Mesh sacrocolpopexy
  • Pelvic prolapse
  • Recurrence

ASJC Scopus subject areas

  • Urology

Cite this

Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse. / Gilleran, Jason P.; Zimmern, Philippe.

In: BJU International, Vol. 103, No. 8, 04.2009, p. 1090-1094.

Research output: Contribution to journalArticle

@article{aadc993fb672434681303c3e615f7de6,
title = "Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse",
abstract = "Objective To report the short- and intermediate- term outcome of safety and efficacy after abdominal-mesh sacrocolpopexy (MSC) for recurrent anterior, posterior and vault ('triple-compartment') pelvic organ prolapse (POP). Patients and methods In a database review we identified non-neurogenic women who had MSC for recurrent triple-compartment POP and with a ≥6-month cystographic follow-up. The preoperative evaluation included a history, physical examination, Urogenital Distress Inventory (UDI-6) and visual analogue quality-of-life (QoL) questionnaires, urodynamic studies, and a standing lateral voiding cysto-urethrogram (VCUG) with rest-strain views. All surgery as performed by the same surgeon, using polypropylene (Marlex) mesh. Perioperative data, the VCUG at 6 months, and interval pelvic examinations were recorded. RESULTS Between 2000 and 2006, 29 postmenopausal women (Caucasian, mean age 64 years, sd 11) underwent MSC. The mean (sd, range) operative duration was 228 (75, 170-340) min, the estimated blood loss 150 (100) mL and the inpatient stay 3 (1) days. At a mean (sd) follow-up of 23 (16) months, the physical examination showed no evidence of POP of grade ≥2, with mean POP-Quantification scores of -2.8 (0.4), -2.9 (0.4) and -9.3 (0.8) for points A a, A p and C, respectively. Two patients (8{\%}) had evidence of grade ≥2 cystocele at the 6-month VCUG. After MSC, four of the six UDI and the QoL scores were significantly lower at the last follow-up than at baseline, with no change in sexual or defecatory function. CONCLUSIONS The Objective and subjective improvement at the short and intermediate follow-up after MSC suggest that this is a safe and effective treatment for recurrent triple-compartment POP.",
keywords = "Cystocele, Mesh sacrocolpopexy, Pelvic prolapse, Recurrence",
author = "Gilleran, {Jason P.} and Philippe Zimmern",
year = "2009",
month = "4",
doi = "10.1111/j.1464-410X.2008.08296.x",
language = "English (US)",
volume = "103",
pages = "1090--1094",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse

AU - Gilleran, Jason P.

AU - Zimmern, Philippe

PY - 2009/4

Y1 - 2009/4

N2 - Objective To report the short- and intermediate- term outcome of safety and efficacy after abdominal-mesh sacrocolpopexy (MSC) for recurrent anterior, posterior and vault ('triple-compartment') pelvic organ prolapse (POP). Patients and methods In a database review we identified non-neurogenic women who had MSC for recurrent triple-compartment POP and with a ≥6-month cystographic follow-up. The preoperative evaluation included a history, physical examination, Urogenital Distress Inventory (UDI-6) and visual analogue quality-of-life (QoL) questionnaires, urodynamic studies, and a standing lateral voiding cysto-urethrogram (VCUG) with rest-strain views. All surgery as performed by the same surgeon, using polypropylene (Marlex) mesh. Perioperative data, the VCUG at 6 months, and interval pelvic examinations were recorded. RESULTS Between 2000 and 2006, 29 postmenopausal women (Caucasian, mean age 64 years, sd 11) underwent MSC. The mean (sd, range) operative duration was 228 (75, 170-340) min, the estimated blood loss 150 (100) mL and the inpatient stay 3 (1) days. At a mean (sd) follow-up of 23 (16) months, the physical examination showed no evidence of POP of grade ≥2, with mean POP-Quantification scores of -2.8 (0.4), -2.9 (0.4) and -9.3 (0.8) for points A a, A p and C, respectively. Two patients (8%) had evidence of grade ≥2 cystocele at the 6-month VCUG. After MSC, four of the six UDI and the QoL scores were significantly lower at the last follow-up than at baseline, with no change in sexual or defecatory function. CONCLUSIONS The Objective and subjective improvement at the short and intermediate follow-up after MSC suggest that this is a safe and effective treatment for recurrent triple-compartment POP.

AB - Objective To report the short- and intermediate- term outcome of safety and efficacy after abdominal-mesh sacrocolpopexy (MSC) for recurrent anterior, posterior and vault ('triple-compartment') pelvic organ prolapse (POP). Patients and methods In a database review we identified non-neurogenic women who had MSC for recurrent triple-compartment POP and with a ≥6-month cystographic follow-up. The preoperative evaluation included a history, physical examination, Urogenital Distress Inventory (UDI-6) and visual analogue quality-of-life (QoL) questionnaires, urodynamic studies, and a standing lateral voiding cysto-urethrogram (VCUG) with rest-strain views. All surgery as performed by the same surgeon, using polypropylene (Marlex) mesh. Perioperative data, the VCUG at 6 months, and interval pelvic examinations were recorded. RESULTS Between 2000 and 2006, 29 postmenopausal women (Caucasian, mean age 64 years, sd 11) underwent MSC. The mean (sd, range) operative duration was 228 (75, 170-340) min, the estimated blood loss 150 (100) mL and the inpatient stay 3 (1) days. At a mean (sd) follow-up of 23 (16) months, the physical examination showed no evidence of POP of grade ≥2, with mean POP-Quantification scores of -2.8 (0.4), -2.9 (0.4) and -9.3 (0.8) for points A a, A p and C, respectively. Two patients (8%) had evidence of grade ≥2 cystocele at the 6-month VCUG. After MSC, four of the six UDI and the QoL scores were significantly lower at the last follow-up than at baseline, with no change in sexual or defecatory function. CONCLUSIONS The Objective and subjective improvement at the short and intermediate follow-up after MSC suggest that this is a safe and effective treatment for recurrent triple-compartment POP.

KW - Cystocele

KW - Mesh sacrocolpopexy

KW - Pelvic prolapse

KW - Recurrence

UR - http://www.scopus.com/inward/record.url?scp=63449111846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63449111846&partnerID=8YFLogxK

U2 - 10.1111/j.1464-410X.2008.08296.x

DO - 10.1111/j.1464-410X.2008.08296.x

M3 - Article

C2 - 19154495

AN - SCOPUS:63449111846

VL - 103

SP - 1090

EP - 1094

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 8

ER -