2024 Volume 115 Issue 2 Pages 53-63
(Introduction) Patients with severe pelvic organ prolapse (POP) are currently being treated with robot-assisted or laparoscopic sacrocolpopexy (LSC). LSC is recognized as being more secure and more effective than transvaginal mesh surgery (TVM). However, favorable postoperative outcomes occur even in patients treated with TVM using ORIHIME® mesh. We compared the differences in postoperative outcomes and complication rates between patients who underwent either of these two methods using ORIHIME® mesh.
(Material and methods) We retrospectively evaluated 95 patients with POP. In our hospital, 41 patients were treated by LSC, whereas 54 were treated by TVM. We measured the changes in symptoms before and after surgery using the IPSS, OABSS, and ICIQ-SF, and 1-h pad weight testing and complication rates.
(Result) Between 3 and 12 months following surgery, both groups' residual urine volume and IPSS plus QOL score significantly decreased. The pad test results revealed a significant decrease 3 months after surgery in the TVM group. From 3 to 12 months after surgery in the TVM group for all patients and patients with POP scored ≤ stage 3, and at 12 months after surgery in the LSC group for all patients, OABSS and ICIQ-SF scores declined significantly. There were no statistically significant differences in the rate of urinary incontinence, mesh exposure after surgery between the two groups. The rate of prolapse recurrence in the TVM group was as low as in the LSC group among patients with stage 2 or 3 POP.
(Conclusion) TVM using ORIHIME® mesh has a favorable postoperative course compared to LSC at 1 year postoperatively. TVM surgery should be preferentially considered for patients scored ≤ stage 3 POP-Q.
