Transvaginal repair of anterior vaginal wall prolapse with polyvinylidene fluoride   (PVDF) mesh: an alternative for previously restricted materials?

Mohammad Javad Eslami1 & Mahtab Zargham1 & Farshad Gholipour2 &   Mohammadreza   Hajian3 & Katayoun Bakhtiari4 & Sakineh Hajebrahimi5 & Melina   Eghbal6 & Ziba Farajzadegan7

Received: 4 June 2021 /Accepted: 8 August 2021

# The International Urogynecological Association 2021

Abstract

Introduction and hypothesis To study the mid-term safety and functional outcomes of   transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF)   mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT).

Methods Between 2015 and 2020, we prospectively includedwomen with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of   the prolapse using PVDF mesh in two medical centers.We followed all patients for at   least   12 months. We recorded the characteristics of vaginal and sexual symptoms,   urinary incontinence, and prolapse stage pre-and postoperatively using International   Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS),   International   Consultation on Incontinence Questionnaire-Urinary Incontinence-Short   Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system,   respectively.

Results One hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%)   patients.   There was a significant improvement in patients’ vaginal symptoms,urinary   incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully.   The total rates   of   complications and de novo urinary symptoms were 21.3% and 7.4%, respectively.   Significant pain was reported in 17 cases (15.7%).

Conclusion Our findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional   success rates and acceptable complication rates in mid-term follow-up.

Keywords Cystocele . Pelvic organ prolapse . Postoperative complication . Surgical mesh . Treatment outcome

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