Citation Information :
Shanmugham D, Koothan V, Varghese J. Efficacy of Transvaginal Anterior Colporrhaphy reinforced with Mesh in the Treatment of Severe Cystocele. J South Asian Feder Menopause Soc 2018; 6 (1):34-38.
Aim: Repair of cystocele with good anatomic success rate remains the challenge for the gynecologists. Use of mesh in cystocele repair is still a controversy with regard to its efficacy and safety. The aim of our study is to evaluate the efficacy and safety of transvaginal anterior colporrhaphy reinforced (ACR) with partially absorbable mesh in the management of severe cystocele.
Materials and methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology based on the surgeries performed between 2011 and 2013. The inclusion criteria were women with grades III and IV cystocele and had undergone vaginal hysterectomy with ACR with mesh.
Results: Forty-two women were included in the study. The primary outcome measured was the efficacy of the mesh in terms of anatomical success rate. The secondary outcome was mesh safety. The anatomic success rate was 93% and the mesh erosion rate was 2.3%.
Conclusion: Transvaginal ACR with partially absorbable mesh in the management of severe cystocele is safe and associated with encouraging anatomic success rate. However, the choice of surgery needs careful selection, considering patients at risk for recurrence.
Clinical significance: The choice of mesh inlay cystocele repair may be individualized and recommended especially in grade IV cystocele, recurrent cystocele, scanty and weak perivesical fascia, to improve long-term outcome.
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