Is Posterior Transvaginal Mesh Surgery Using PTFE Mesh ORIHIME Effective and Safe for Advanced Posterior Vaginal Prolapse?

Le résumé fourni par la source

OBJECTIVES: To examine the efficacy and safety of posterior tension-free vaginal mesh (TVM-P) surgery using polytetrafluoroethylene (PTFE) mesh (ORIHIME) for advanced posterior vaginal prolapse. METHODS: A retrospective cohort study was conducted involving patients who underwent TVM-P surgery with PTFE mesh for pelvic organ prolapse quantification stage III or IV posterior vaginal prolapse between December 2018 and March 2023. All patients were followed for a minimum of 1 year postoperatively. The primary outcome was the recurrence rate in the operated compartment. Secondary outcomes comprised recurrence in other pelvic compartments, mesh-related complications, and an analysis of risk factors for recurrence. RESULTS: Seventy-one patients underwent TVM-P surgery during the study period. The recurrence rate in the operated compartment was 4.2%, while the overall recurrence rate was 18.3%. Eleven cases of recurrence occurred within the first year; 13 cases were observed within 3 years postsurgery. Patients who experienced recurrence in other compartments had a significantly higher incidence of preoperative Ba point score ≥ -1 versus the nonrecurrence group. Preoperative Ba point score ≥ -1 was associated with a higher risk of recurrence in other compartments (crude odds ratio: 4.17, 95% confidence interval: 1.03-26.7; adjusted odds ratio: 2.58, 95% confidence interval: 0.56-11.8). CONCLUSIONS: The recurrence rate in the operated compartment following TVM-P surgery for advanced rectoceles or enteroceles was 4.2%. These findings suggest that TVM-P surgery using PTFE mesh may be an effective surgical option for treating severe posterior vaginal pelvic organ prolapse.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.