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What to Do With Recurrent Prolapse After Vaginal Mesh Failure?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Norinho de Oliveira, Paula Bourdel, Nicolas Rabischong, Benoit Canis, Michel Botchorishvili, Revaz
Description	Author Affiliation: Norinho de Oliveira P ( Department of Obstetrics and Gynecology, Centro Hospitalar Entre Douro e Vouga, EPE, Santa Maria da Feira, Portugal. Electronic address: paulanoris@gmail.com.); Bourdel N ( Department of Gynecological Surgery, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont Ferrand, France.); Rabischong B ( Department of Gynecological Surgery, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont Ferrand, France.); Canis M ( Department of Gynecological Surgery, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont Ferrand, France.); Botchorishvili R ( Department of Gynecological Surgery, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont Ferrand, France.)
Abstract	STUDY OBJECTIVE: To show that in selected cases laparoscopic sacrocolpopexy can be used for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery. METHODS: Step-by-step examination of the technique using an educative video. Institutional review board approval was obtained. SETTING: The authors describe two clinical cases of treatment of recurrent pelvic organ prolapse, after a vaginal mesh surgery, using laparoscopic sacrocolpopexy. PATIENTS: A 56-year old patient (para 3, gravida 2) presented with the sentation of bulging in the vagina. On physical examination, the patient had a grade 2-3 vaginal apical prolapse and a stage 4 rectocele. She had a slight mesh contraction but no vaginal extrusion and no pain were reported. Eleven years before, she had a vaginal total hysterectomy for pelvic organ prolapse correction and one year before she had a vaginal prolapse repair using a synthetic mesh. A laparoscopic sacrocolpopexy with bilateral ooforectomy was performed. The second case is of a 54-year old patient (para 2, gravida 2) that presented stress urinary incontinence. On physical examination, the patient had a grade 3 uterine prolapse and grade 2 cystocele. Eleven years before she had a vaginal prolapse repair using a synthetic mesh and a miduretral sling for stress urinary incontinence. Two years before, she had the miduretal sling removed for recurrent urinary infections and dysuria. A laparoscopic sub-total hysterectomy with salpingectomy and ovarian conservation, sacrocolpopexy and a Burch colposuspension was performed. MEASUREMENTS AND MAIN RESULTS: The procedures and postoperative recovery were uneventful. No minor or major complications occurred. The patients were discharged three days after surgery. CONCLUSION: Laparoscopic sacrocolpopexy is a promising approach for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery. It appears to be feasible, safe, and effective.
File Format	HTM / HTML
ISSN	15534650
Issue Number	2
Volume Number	23
e-ISSN	15534669
Journal	Journal of Minimally Invasive Gynecology
Language	English
Publisher	Elsevier
Publisher Date	2016-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Hysterectomy, Vaginal Humans Middle Aged Video-audio Media Organ Sparing Treatments Gynecologic Surgical Procedures Sacrococcygeal Region Journal Article Feasibility Studies Case Reports Surgical Mesh Surgery Female Adverse Effects Uterine Prolapse Vagina Treatment Outcome Laparoscopy Salpingectomy Pelvic Organ Prolapse Pathology Cystocele Vaginal Diseases Discipline Gynecology Methods Equipment Failure
Content Type	Text
Resource Type	Case study Article
Subject	Obstetrics and Gynecology

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