Open Access
CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2019; 79(09): 959-968
DOI: 10.1055/a-0984-6614
GebFra Science
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Significant Improvement in Quality of Life, Positive Effect on Sexuality, Lasting Reconstructive Result and Low Rate of Complications Following Cystocele Correction Using a Lightweight, Large-Pore, Titanised Polypropylene Mesh

Final Results of a National, Multicentre Observational Study Article in several languages: English | deutsch
Tina Cadenbach-Blome
1   Asklepios Klinik Altona, Hamburg, Germany
,
Markus Grebe
2   Städtisches Krankenhaus, Dresden, Germany
,
Mathias Mengel
3   Klinikum Oberlausitzer Bergland gGmbH, Zittau, Germany
,
Friedrich Pauli
4   Klinikum Augsburg, Augsburg, Germany
,
Angelika Greser
5   pfm medical ag, Köln, Germany
,
Christian Fünfgeld
6   Klinik Tettnang GmbH, Tettnang, Germany
› Author Affiliations
Further Information

Publication History

received 07 April 2019
revised 22 July 2019

accepted 25 July 2019

Publication Date:
11 September 2019 (online)

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Abstract

Introduction Patients who suffer from pelvic organ prolapse can experience severe limitations in their quality of life. To improve the quality of life of women affected and achieve a stable reconstruction, surgical therapy is often indispensable. In conventional prolapse surgery, the rate of recurrence is high. For this reason, alloplastic mesh has been implanted increasingly in recent years to reconstruct the anatomy of the pelvic floor organs. Even if the anatomical result can be significantly improved as a result, the mesh-induced complications have been the subject of controversial discussion. In this national, multicentre study, the quality of life, anatomical result as well as the rate of complications following the implantation of an alloplastic mesh for the correction of a cystocele were investigated.

Method Fifty-four patients with symptomatic ≥ grade II were included in this prospective, national, multicentre study. The study participants were implanted with a titanised polypropylene mesh (TiLOOP® PRO A, pfm medical ag). The follow-up observation period was 12 months. Primary as well as repeat procedures were taken into account. The anatomic result of the pelvic floor reconstruction was quantified using the POP-Q system. Data on quality of life and sexuality were collected using validated questionnaires. All complications which occurred were documented and evaluated by an independent committee.

Results On average, the patients were in line with the census. An improvement in quality of life was able to be determined during the study in all domains investigated (p < 0.001, Wilcoxon test). Minus incorrect entries and incorrect reports, a total of 19 reports of adverse events in 15 patients were evaluated by the end of the study. The rate of recurrence in the anterior compartment was 4.3%.

Conclusion In the reconstruction of the anatomical position of the pelvic floor organs given the presence of a symptomatic cystocele, the implantation of a third-generation alloplastic mesh achieves very good results. Affected patients benefit from the anatomical stability as well as a significant improvement in quality of life, whereby the risks are justifiable.