Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;28(1):21-7.
doi: 10.4103/0970-1591.94949.

Trans-vaginal total pelvic floor repair using customized prolene mesh: A safe and cost-effective approach for high-grade pelvic organ prolapse

Samit Chaturvedi  1 , Rajesh Bansal, Priyadarshi Ranjan, M S Ansari, Deepa Kapoor, Rakesh Kapoor
Affiliations

Trans-vaginal total pelvic floor repair using customized prolene mesh: A safe and cost-effective approach for high-grade pelvic organ prolapse

Samit Chaturvedi et al. Indian J Urol. 2012 Jan.

Abstract

Aims: To assess safety, efficacy, and cost-effectiveness of trans-vaginal total pelvic floor repair with customized prolene mesh in patients with high-grade pelvic organ prolapse.

Materials and methods: A total of 32 patients, who underwent trans-vaginal total pelvic floor repair using a customized prolene mesh from January 2007 to June 2010 for grade III and IV pelvic organ prolapse, were analyzed retrospectively. Prolapse was graded using Pelvic Organ Prolapse Quantification system of International Continence Society. Patients were evaluated for symptoms associated with prolapse pre- and postoperatively.

Results: Of the 32 patients, 18 were grade IV uterine prolapse, 10 were grade III uterine prolapse, and 4 were grade IV vault prolapse. Twenty-eight patients underwent vaginal hysterectomy at the time of repair. All the patients had associated anterior and posterior prolapse of varying degree. Follow-up ranged from 6 to 42 months. All patients had symptomatic relief after surgery. There were no intraoperative rectal or bladder injuries. Early complications were perineal pain (30), de novo urgency (4), vaginal discharge (3), vaginal wall hematoma (2), and failure to void (2). Two patients had vaginal erosion of mesh.

Conclusions: Trans-vaginal total pelvic floor repair using a customized prolene mesh is safe and effective treatment for comprehensive repair of high-grade pelvic organ prolapse. The use of this custom-made prolene mesh makes the procedure very cost-effective and affordable. The reduction in cost is about 25-30 times with the use of this mesh when compared with commercially available variety.

Keywords: Customized prolene mesh; prolapse; trans vaginal tape.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Customized prolene mesh, diagrammatic representation with measurements, (b) Customized mesh before placement, (c) Mesh as it will be positioned inside
Figure 2
Figure 2
(a) Suture passer needles, anterior two pronged, (b) posterior curved
Figure 3
Figure 3
(a) Diagrammatic representation of mesh position, lateral view, (b) Anterior view, Bladder (B), Vagina (V), Rectum (R), ischial spone (I)
Figure 4
Figure 4
(a) Operative procedure, high-grade prolapse, (b) Saline dissection of vaginal flaps, (c) Anterior suture placement, (d) Placement of posterior limbs of mesh
See this image and copyright information in PMC

References

    1. Beck RP, McCormick S, Nordstrom L. A 25-year experience with 519 anterior colporrhaphy procedures. Obstet Gynecol. 1991;78:1011–8. - PubMed
    1. Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006;194:1455–61. - PubMed
    1. Hunskaar S, Burgio K, Clark A. Epidemiology of urinary and fecal Q1 incontinence and pelvic organ prolapse. In: Abrams P, Cordozo L, Koury S, editors; Abrams P, Cordozo L, Koury S, Wein A, editors. Third international consultation on incontinence. 1st ed. Paris: Health Publication; 2005.
    1. Moalli PA, Jones Ivy S, Meyn LA, Zyczynski HM. Risk factors associated with pelvic floor disorders in women undergoing surgical repair. Obstet Gynecol. 2003;101:869–74. - PubMed
    1. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89:501–6. - PubMed