Transvaginal treatment of anterior and apical genital prolapses using an Ultra lightweight mesh: Restorelle® Direct Fix™. A retrospective study on feasibility and morbidity - 29/10/18
, Pauline Bertherat b, Anne Gauthier c, Richard Villet d, Francesco Del Piano e, David Hamid f, Hervé Fernandez c, Pierre-Louis Broux g, Delphine Salet-Lizée d, Etienne Vincens d, Pierre Ntshaykolo h, Philippe Debodinance i, Philippe Pocholle j, Yannick Thirouard b, Renaud de Tayrac lBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Background |
Vaginal mesh safety information is limited, especially concerning single incision techniques using ultra lightweight meshes for the treatment of anterior pelvic organ prolapse (POP).
Objective |
To determine the intraoperative and postoperative complication rates after anterior POP repair involving an ultralight mesh (19g/m2): Restorelle® Direct Fix™.
Methods |
A case series of 218 consecutive patients, operated on between January 2013 and December 2016 in ten tertiary and secondary care centres, was retrospectively analyzed. Eligible patients had POP vaginal repair (recurrent or not) planned with anterior Restorelle® Direct Fix™ mesh (with or without posterior mesh). Surgical complications were graded using the Clavien-Dindo classification.
Results |
Intraoperative complications were bladder wound (0.5%), rectal wound (0.5%), ureteral injuries (0.9%). 98.2% of the patient did not have per operative complications. We observed one fail of procedure. Early complications mainly included urinary retention (8.7%) urinary tract infections (5.5%) and haematoma (2.7%). One haematoma required surgical treatment and another, embolization. 80.7% of the patient did not have complications during hospitalization and 80.3% did not have complication at the follow up visit. None of the analyzed factors (age, body mass index, surgical history, grade of prolapse or concomitant procedure) was significantly associated with the risk of perioperative complications. A total of 2.8% patients had grade III complications according Clavien Dindo. None had grade IV or V.
Conclusions |
This multicentre case-series on the early experience of the use of anterior Restorelle® Direct Fix™ mesh showed a satisfactory technical feasibility and a low rate of grade III complications according Clavien Dindo. Long term studies are necessary to assess anterior Restorelle® Direct Fix™ mesh performances and to appraise patient satisfaction feedback.
Le texte complet de cet article est disponible en PDF.Keywords : Pelvic organ prolapse, Pelvic organ prolapse surgery, Vaginal mesh complications, Restorelle® Direct Fix™
Plan
Vol 47 - N° 9
P. 443-449 - novembre 2018 Retour au numéro
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