Polypropylene mesh vs. site-specific repair in the treatment of anterior vaginal wall prolapse: preliminary results of a randomized clinical trial

Abstract

Objective: Pelvic organ prolapse is a disorder caused by the imbalance between the forces responsible for supporting the pelvic organs in their normal position and those that tend to expel them from the pelvis. Anterior vaginal wall prolapse, known as cystocele, is the most common form of prolapse and can result from lesions in different topographies of the endopelvic fascia. Currently, a woman has an 11% risk of being submitted to a surgical procedure to correct pelvic floor disorder, and a 29% chance of being reoperated due to failure in the first surgery.

Methods: A prospective randomized study was conducted to compare the use of polypropylene mesh with site-specific repair in the surgical treatment of anterior vaginal prolapse. Thirty-two patients aged between 50 and 75 years, who had previous vaginal prolapse at stage III or IV, or prolapse recurrence, were operated. Mean follow-up was 8.5 months.

Results: The results demonstrate the superiority of the anatomical outcomes with the use of polypropylene mesh over site-specific repair. Regarding surgical morbidity, shorter operative time was observed for the mesh group.

Conclusion: The results observed in this study indicate the superiority of anatomical results obtained with the use of polypropylene mesh over site-specific repair.