Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 1 , Pages 53-59, March 2009

Suburethral Slingplasty Using a Self-fashioned Gynemesh for Treating Urinary Incontinence and Anterior Vaginal Wall Prolapse

  • Chi-Feng Su

      Affiliations

    • Department of Obstetrics and Gynecology, Kuang Tien General Hospital
    • ,
  • Soo-Cheen Ng

      Affiliations

    • Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
    • ,
  • Kwong-Pang Tsui

      Affiliations

    • Department of Obstetrics and Gynecology, Cheng Ching Hospital, Taichung, Taiwan
    • ,
  • Gin-Den Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Gin-Den Chen, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan
    • ,
  • Horng-Jyh Tsai

      Affiliations

    • Department of Obstetrics and Gynecology, Kuang Tien General Hospital

Accepted 2 April 2008.

Article Outline

Summary 

Objective

This study was conducted to evaluate the effectiveness of self-fashioned Gynemesh for the concomitant treatment of urinary incontinence and anterior vaginal wall prolapse, and the factors involved in mesh erosion.

Materials and Methods

From March 2004 to September 2006, 65 women with urinary incontinence, with or without pelvic organ prolapse or prior surgery for prolapse or incontinence, were recruited for this study. A self-fashioned Gynemesh was used for the concomitant treatment of urinary incontinence and anterior vaginal wall prolapse. Patients in this study underwent suburethral slingplasty and/or concomitant pelvic reconstructive operations. A general linear model univariate analysis was performed to assess the relationships between mesh erosion and various variables.

Results

The mean postoperative follow-up was 33 months. Those patients with anterior wall prolapse presented as completely cured postoperatively. The cure rate for urinary incontinence was 80%, and the improvement rate was 17%. Vaginal mesh erosion was discovered in four patients (6%) during the postoperative follow-up. These four patients remained continent after the removal of the eroded mesh. The interactive effects for mesh erosion by a general linear model analysis were menopausal women with advanced anterior vaginal wall prolapse (p < 0.05) and women with advanced anterior vaginal wall prolapse with concomitant sacrospinous ligament fixation (p < 0.05).

Conclusion

We found that using self-fashioned Gynemesh for tension-free suburethral and anterior vaginal slingplasty provided a high success rate (97%) in the 3 years of follow-up. Mechanical rejection may be one of the causes of vaginal mesh erosion.

Key Words:  suburethral slings , surgical mesh , urinary stress incontinence , vaginal prolapse

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PII: S1028-4559(09)60036-X

doi:10.1016/S1028-4559(09)60036-X

Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 1 , Pages 53-59, March 2009

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