The Results of Grade IV Cystocele Repair Using Mesh
<p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Purpose:</strong> To evaluate the...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences
2004-06-01
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| Series: | Urology Journal |
| Online Access: | http://www.urologyjournal.org/index.php/uj/article/view/297 |
| _version_ | 1818807813666766848 |
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| author | Mohammad Ali Zargar-Shoshtari Maryam Emami K Zargar M Jamshidi |
| author_facet | Mohammad Ali Zargar-Shoshtari Maryam Emami K Zargar M Jamshidi |
| author_sort | Mohammad Ali Zargar-Shoshtari |
| collection | DOAJ |
| description | <p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Purpose:</strong> To evaluate the results of grade IV cystocele repair by 4-corner bladder and bladder neck suspension technique, using prolene mesh.<span style="mso-spacerun: yes;"> </span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Material and Methods:</strong> Thirty-one women with a median age of 61 years and severe anterior vaginal wall prolapse (grade IV cystocele) were treated by 4-corner bladder and bladder neck suspension technique, using prolene mesh. Of these, 3 had associated uterine prolapse, rectocele, and enterocele, one had rectocele and enterocele, and 18 had rectocele only. In these cases, pelvic floor defects were also repaired simultaneously and in 3, vaginal hysterectomy was done. Twelve patients had a previous failed cystocele repair. In a 32-month follow-up, the patients were evaluated with vaginal examination and upright cystography. Urinary continence during increased intra-abdominal pressure was also assessed, based on subjective symptoms. </span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Results:</strong> None of the patients had cystocele recurrence. Urinary continence during increased intra-abdominal pressure was seen in all of the patients. Intraoperative rectal or bladder injury did not occur. Transfusion was not required in any of the cases. </span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small; font-family: Times New Roman;">Early complications (6 to 8 weeks postoperatively) included irritative urinary symptom in 17 patients, of whom, 8 had documented urinary tract infection that were treated successfully. Late complications were spotting in 3 cases (two were treated with topical estrogen and vaginal mucosal repair was done in one), dyspareunia in 4 sexually active patients, changes in urination pattern in 28 (improved significantly with behavioral therapy), long-term urge incontinence (> 8 weeks) in 5 (medical treatment was successful in these patients), and prolonged intermittent catheterization in 1. Pelvic abscess and migration of mesh were not observed. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Conclusion:</strong> According to our findings, using mesh in patients with grade IV cystocele, who had a previous failed surgery or weakness in supportive pelvic tissue, is an appropriate treatment modality. </span></span></p> |
| first_indexed | 2024-12-18T19:31:38Z |
| format | Article |
| id | doaj.art-ef59ad8b970940819f4610e1b9cb07f3 |
| institution | Directory Open Access Journal |
| issn | 1735-1308 1735-546X |
| language | English |
| last_indexed | 2024-12-18T19:31:38Z |
| publishDate | 2004-06-01 |
| publisher | Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Urology Journal |
| spelling | doaj.art-ef59ad8b970940819f4610e1b9cb07f32022-12-21T20:55:43ZengUrology and Nephrology Research Center, Shahid Beheshti University of Medical SciencesUrology Journal1735-13081735-546X2004-06-0114263267The Results of Grade IV Cystocele Repair Using MeshMohammad Ali Zargar-ShoshtariMaryam EmamiK ZargarM Jamshidi<p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Purpose:</strong> To evaluate the results of grade IV cystocele repair by 4-corner bladder and bladder neck suspension technique, using prolene mesh.<span style="mso-spacerun: yes;"> </span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Material and Methods:</strong> Thirty-one women with a median age of 61 years and severe anterior vaginal wall prolapse (grade IV cystocele) were treated by 4-corner bladder and bladder neck suspension technique, using prolene mesh. Of these, 3 had associated uterine prolapse, rectocele, and enterocele, one had rectocele and enterocele, and 18 had rectocele only. In these cases, pelvic floor defects were also repaired simultaneously and in 3, vaginal hysterectomy was done. Twelve patients had a previous failed cystocele repair. In a 32-month follow-up, the patients were evaluated with vaginal examination and upright cystography. Urinary continence during increased intra-abdominal pressure was also assessed, based on subjective symptoms. </span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Results:</strong> None of the patients had cystocele recurrence. Urinary continence during increased intra-abdominal pressure was seen in all of the patients. Intraoperative rectal or bladder injury did not occur. Transfusion was not required in any of the cases. </span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small; font-family: Times New Roman;">Early complications (6 to 8 weeks postoperatively) included irritative urinary symptom in 17 patients, of whom, 8 had documented urinary tract infection that were treated successfully. Late complications were spotting in 3 cases (two were treated with topical estrogen and vaginal mucosal repair was done in one), dyspareunia in 4 sexually active patients, changes in urination pattern in 28 (improved significantly with behavioral therapy), long-term urge incontinence (> 8 weeks) in 5 (medical treatment was successful in these patients), and prolonged intermittent catheterization in 1. Pelvic abscess and migration of mesh were not observed. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Conclusion:</strong> According to our findings, using mesh in patients with grade IV cystocele, who had a previous failed surgery or weakness in supportive pelvic tissue, is an appropriate treatment modality. </span></span></p>http://www.urologyjournal.org/index.php/uj/article/view/297 |
| spellingShingle | Mohammad Ali Zargar-Shoshtari Maryam Emami K Zargar M Jamshidi The Results of Grade IV Cystocele Repair Using Mesh Urology Journal |
| title | The Results of Grade IV Cystocele Repair Using Mesh |
| title_full | The Results of Grade IV Cystocele Repair Using Mesh |
| title_fullStr | The Results of Grade IV Cystocele Repair Using Mesh |
| title_full_unstemmed | The Results of Grade IV Cystocele Repair Using Mesh |
| title_short | The Results of Grade IV Cystocele Repair Using Mesh |
| title_sort | results of grade iv cystocele repair using mesh |
| url | http://www.urologyjournal.org/index.php/uj/article/view/297 |
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