Early Clinical Experience with Different Mesh in Correction of High-Degree Cystocele

Background

Cystocele is connected to an ingravescent relaxation of uretrovesical support system.

During surgical correction of this disease, a mesh has been introduced to strengthen weak tissue. The aim of the study was to compare different material aspects and various devices.

Methods

From June 2002 to December 2008, 80 patients underwent surgical correction for high-degree cystocele. None of the patients had stress-incontinence. All the patients were studied with cistography and urodynamic test. Three different kinds of mesh were employed, such as: Goretex (26 pt.), Prolene (27 pt.), Bovine Pericardium (27 pt.). During surgery the mesh have been modelled if necessary and fixed by detached sutures.

Results

By comparing the devices: in Goretex group there were excellent results about anatomical correction, in the follow-up too (6 months), good continence and an improving of quality of life; in Prolene group no post-surgery complication, 3 pts. referred urge incontinence resolved in about 3 months. After 6 months a subset of patients reported sensation of foreign vulvar body and moderate dyspareunia; in Bovine Pericardium group we had an intra-operatory difficulty, for its softness a high risk to tear the net itself. No post-surgery complications. No urinary symptoms. After 3 months 5 of the patients referred a sensation of foreign vulvar body and dyspareunia. After 6 months, 4 patients still have the same sensation.

Conclusion

We hypothesize that Goretex mesh is an excellent device for its operator manageability, good anatomical results, and good tolerability. Further investigation is warranted to determine the effect of each of these techniques.