The purpose of this research is to determine the effectiveness and safety of a vaginal mesh intended to resolve multicompartmental prolapse in individuals with substantial vaginal vault prolapse.

Methods

From 2015 to 2020, 67 patients with recurrent apical prolapse ≥ III stage (POP-Q grading) underwent transvaginal vault repair using the isoelastic mesh InGYNious. Operative time, blood transfusions, spontaneous voiding, perioperative issues, postoperative hospital stay, and postoperative complications (early within 30 days and late after 30 days) were also investigated. Following the first preoperative examination, clinical and QoL questionnaires were examined both before and after surgery at the long-term follow-up (> 60 months).

Results

The average surgery duration was 41 ± 21 min, with an estimated blood loss of 50 ± 21 mL. The total number of surgical complications was eight (11.9%). The study discovered significant reductions in the apical (from 1.88 ± 2.59 to −6.73 ± 1.77) and anterior (from 1.34 ± 1.67 to −2.25 ± 0.95) deficiencies, as well as improvements in PQOL (from 67.72 ± 19.25 to 33.74 ± 7.48), PISQ-12 (from 29 to 36), FSFI (from 20 to 29), and FSDS (from 21 to 8). Finally, we identified three cases of full recurrence and only two occurrences needed reoperation.

Conclusions

Transvaginal mesh repair is a safe and effective surgical technique that can treat multi-compartment prolapse, improve anatomical success, and reduce the risk of recurrence in certain patient populations, such as those with significant comorbidities, elderly patients, patients with recurrent POP, or patients with very challenging cases of POP.

Conflicts of Interest

The authors declare no conflicts of interest.

Open Research

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

1P. Dällenbach, “To Mesh or Not to Mesh: A Review of Pelvic Organ Reconstructive Surgery,” International Journal of Women's Health 7 (2015): 331–343.
10.2147/IJWH.S71236
PubMed Web of Science® Google Scholar
2J. W. Moon and H. D. Chae, “Vaginal Approaches Using Synthetic Mesh to Treat Pelvic Organ Prolapse,” Annals of Coloproctology 32, no. 1 (2016): 7–11.
10.3393/ac.2016.32.1.7
PubMed Google Scholar
3A. M. Weber and H. E. Richter, “Pelvic Organ Prolapse,” Obstetrics and Gynecology settembre 106, no. 3 (2005): 615–634.
10.1097/01.AOG.0000175832.13266.bb
PubMed Web of Science® Google Scholar
4A. L. Milani, A. Damoiseaux, J. IntHout, K. B. Kluivers, and M. I. J. Withagen, “Long-Term Outcome of Vaginal Mesh or Native Tissue in Recurrent Prolapse: A Randomized Controlled Trial,” International Urogynecology Journal 29, no. 6 (2018): 847–858.
10.1007/s00192-017-3512-3
PubMed Web of Science® Google Scholar
5W. D. Winkelman, A. M. Modest, and M. L. Richardson, “U.S. Food and Drug Administration Statements About Transvaginal Mesh and Changes in Apical Prolapse Surgery,” Obstetrics and Gynecology 134, no. 4 (2019): 745–752.
10.1097/AOG.0000000000003488
PubMed Google Scholar
6L. L. Ow, Y. N. Lim, P. L. Dwyer, et al., “Native Tissue Repair or Transvaginal Mesh for Recurrent Vaginal Prolapse: What Are the Long-Term Outcomes?,” International Urogynecology Journal 27, no. 9 (2016): 1313–1320.
10.1007/s00192-016-3069-6
PubMed Google Scholar
7https://www.iss.it/documents/20126/9020128/LG_C0014_SIGO_Prolasso+organi+pelvici.pdf/0a33787b-6685-1690-412c-7c73b11da0a2?t=1712222592777.
Google Scholar
8C. Maher, E. Yeung, N. Haya, et al., “Surgery for Women With Apical Vaginal Prolapse,” Cochrane Database of Systematic Reviews 7, no. 7 (2023): CD012376.
PubMed Google Scholar
9E. Yeung, K. Baessler, C. Christmann-Schmid, et al., “Transvaginal Mesh or Grafts or Native Tissue Repair for Vaginal Prolapse,” Cochrane Database of Systematic Reviews 3, no. 3 (2024): CD012079.
PubMed Google Scholar
10A. W. M. Coolen, B. N. Bui, V. Dietz, et al., “The Treatment of Post-Hysterectomy Vaginal Vault Prolapse: A Systematic Review and Meta-Analysis,” International Urogynecology Journal 28, no. 12 (2017): 1767–1783.
10.1007/s00192-017-3493-2
PubMed Web of Science® Google Scholar
11N. T. Okcu, T. Gürbüz, and G. Uysal, “Comparison of Patients Undergoing Vaginal Hysterectomy With Sacrospinous Ligament Fixation, Laparoscopic Hysterectomy With Sacrocolpopexy and Abdominal Hysterectomy With Sacrocolpopexy in Terms of Postoperative Quality of Life and Sexual Function,” Journal of Gynecology Obstetrics and Human Reproduction 50, no. 4 (2021): 101977.
10.1016/j.jogoh.2020.101977
PubMed Web of Science® Google Scholar
12K. R. Husby, M. D. Larsen, G. Lose, and N. Klarskov, “Surgical Repair of Vaginal Vault Prolapse; A Comparison Between Ipsilateral Uterosacral Ligament Suspension and Sacrospinous Ligament Fixation-a Nationwide Cohort Study,” International Urogynecology Journal 32, no. 6 (2021): 1441–1449.
10.1007/s00192-020-04515-x
PubMed Web of Science® Google Scholar
13M. Brunes, M. Ek, A. Drca, et al., “Vaginal Vault Prolapse and Recurrent Surgery: A Nationwide Observational Cohort Study,” Acta Obstetricia et Gynecologica Scandinavica 101, no. 5 (2022): 542–549.
10.1111/aogs.14341
PubMed Web of Science® Google Scholar
14A. Kuszka, A. Brandt, A. Niesel, et al., “3 Year Outcome After Treatment of Uterovaginal Prolapse With a 6-Point Fixation Mesh,” European Journal of Obstetrics, Gynecology, and Reproductive Biology 255 (2020): 160–164.
10.1016/j.ejogrb.2020.10.030
PubMed Web of Science® Google Scholar
15A. Brandt, A. Kuszka, A. Niesel, et al., “1-Year Outcome After Treatment of Uterovaginal Prolapse With a 6-Point Fixation Mesh,” Neurourology and Urodynamics 38, no. 4 (2019): 1129–1134.
10.1002/nau.23968
PubMed Web of Science® Google Scholar
16R. Geoffrion and M. Larouche, “Guideline No. 413: Surgical Management of Apical Pelvic Organ Prolapse in Women,” Journal of Obstetrics and Gynaecology Canada 43, no. 4 (2021): 511–523.e1.
10.1016/j.jogc.2021.02.001
PubMed Web of Science® Google Scholar
17C. Y. W. Chan, R. A. Fernandes, H. H. Yao, H. E. O'Connell, V. Tse, and J. Gani, “A Systematic Review of the Surgical Management of Apical Pelvic Organ Prolapse,” International Urogynecology Journal 34, no. 4 (2023): 825–841.
10.1007/s00192-022-05408-x
PubMed Web of Science® Google Scholar
18O. Gluck, M. Blaganje, N. Veit-Rubin, et al., “Laparoscopic Sacrocolpopexy: A Comprehensive Literature Review on Current Practice,” European Journal of Obstetrics, Gynecology, and Reproductive Biology 245 (2020): 94–101.
10.1016/j.ejogrb.2019.12.029
PubMed Web of Science® Google Scholar
19K. B. Kluivers, M. Kamping, A. L. Milani, J. IntHout, and M. I. Withagen, “Subjective Outcomes 12 Years After Transvaginal Mesh Versus Native Tissue Repair in Women With Recurrent Pelvic Organ Prolapse; a Randomized Controlled Trial,” International Urogynecology Journal 34, no. 7 (2023): 1645–1651.
10.1007/s00192-022-05442-9
PubMed Web of Science® Google Scholar
20 Pelvic Organ Prolapse, “ACOG Practice Bulletin, Number 214,” Obstetrics and Gynecology 134, no. 5 (2019): e126–e142.
10.1097/AOG.0000000000003519
PubMed Google Scholar
21B. T. Haylen, C. F. Maher, M. D. Barber, et al., “An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP),” Neurourology and Urodynamics 35, no. 2 (2016): 137–168.
10.1002/nau.22922
PubMed Web of Science® Google Scholar
22A. Mowat, C. Maher, and A. Pelecanos, “Can the Learning Curve of Laparoscopic Sacrocolpopexy be Reduced by a Structured Training Program?,” Female Pelvic Medicine & Reconstructive Surgery 24, no. 4 (2018): 272–276.
10.1097/SPV.0000000000000441
PubMed Google Scholar
23F. C. Chuang, Y. M. Chou, L. Y. Wu, T. H. Yang, W. H. Chen, and K. H. Huang, “Laparoscopic Pectopexy: The Learning Curve and Comparison With Laparoscopic Sacrocolpopexy,” International Urogynecology Journal 33, no. 7 (2022): 1949–1956.
10.1007/s00192-021-04934-4
PubMed Web of Science® Google Scholar
24C. J. Wu, K. J. Huang, W. C. Chang, Y. X. Li, L. H. Wei, and B. C. Sheu, “Analyzing the Learning Curve of Vaginal Pelvic Reconstruction Surgery With and Without Mesh by the Cumulative Summation Test (CUSUM),” Scientific Reports 12, no. 1 (2022): 7025.
10.1038/s41598-022-11039-5
CAS PubMed Web of Science® Google Scholar
25C. M. Glazener, S. Breeman, A. Elders, et al., “Mesh, Graft, or Standard Repair for Women Having Primary Transvaginal Anterior or Posterior Compartment Prolapse Surgery: Two Parallel-Group, Multicentre, Randomised, Controlled Trials (PROSPECT),” Lancet (London, England) 389, no. 10067 (2017): 381–392.
10.1016/S0140-6736(16)31596-3
PubMed Web of Science® Google Scholar
26S. Cosma, G. Menato, M. Preti, et al., “Advanced Utero-Vaginal Prolapse and Vaginal Vault Suspension: Synthetic Mesh vs Native Tissue Repair,” Archives of Gynecology and Obstetrics 289, no. 5 (2014): 1053–1060.
10.1007/s00404-013-3104-5
PubMed Web of Science® Google Scholar
27F. Cadeddu, P. Sileri, M. Grande, E. De Luca, L. Franceschilli, and G. Milito, “Focus on Abdominal Rectopexy for Full-Thickness Rectal Prolapse: Meta-Analysis of Literature,” Techniques in Coloproctology 16, no. 1 (2012): 37–53.
10.1007/s10151-011-0798-x
CAS PubMed Web of Science® Google Scholar
28M. C. Schiavi, G. Perniola, V. Di Donato, et al., “Severe Pelvic Organ Prolapse Treated by Vaginal Native Tissue Repair: Long-Term Analysis of Outcomes in 146 Patients,” Archives of Gynecology and Obstetrics 295, no. 4 (2017): 917–922.
10.1007/s00404-017-4307-y
PubMed Web of Science® Google Scholar
29M. C. Schiavi, O. DʼOria, P. Faiano, et al., “Vaginal Native Tissue Repair for Posterior Compartment Prolapse: Long-Term Analysis of Sexual Function and Quality of Life in 151 Patients,” Female Pelvic Medicine & Reconstructive Surgery 24, no. 6 (2018): 419–423.
10.1097/SPV.0000000000000463
PubMed Web of Science® Google Scholar
30C. Cassagne, F. Perriard, A. Cornille, J. Salerno, and L. Panel, “Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery With no Mesh,” Journal of Clinical Medicine 12, no. 6 (2023): 2212.
10.3390/jcm12062212
PubMed Web of Science® Google Scholar

Volume17, Issue4

July 2025

e70021

Is Vaginal Prosthetic Surgery Always to Be Avoided? Analysis of the Efficacy and Safety of Vaginal Mesh With 3 Levels-De Lancey Attachment in Women With Recurrent Vaginal Vault Prolapse

ABSTRACT

Objectives

Methods

Results

Conclusions

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Is Vaginal Prosthetic Surgery Always to Be Avoided? Analysis of the Efficacy and Safety of Vaginal Mesh With 3 Levels-De Lancey Attachment in Women With Recurrent Vaginal Vault Prolapse

ABSTRACT

Objectives

Methods

Results

Conclusions

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Related

Information