open access

Vol 88, No 11 (2017)
ORIGINAL PAPERS Gynecology
Published online: 2017-12-05
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The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously — results controlled with a pelvic floor ultrasound. A preliminary study

Edyta Wlaźlak, Tomasz Kluz, Andrzej Wróbel, Magda Krzycka, Grzegorz Surkont
DOI: 10.5603/GP.a2017.0105
·
Pubmed: 29303210
·
Ginekol Pol 2017;88(11):579-584.

open access

Vol 88, No 11 (2017)
ORIGINAL PAPERS Gynecology
Published online: 2017-12-05

Abstract

Objectives: It is controversial whether pelvic organ prolapse and stress urinary incontinence (SUI) should be treated simultaneously with a single surgery or separately with two procedures. The pre-pubic four-arm NAZCA-TC® mesh was invented to treat cystocele and SUI with a single procedure. The objective of this study is to analyze short-term results after the implantation of NAZCA-TC mesh.

Material and methods: A total of 18 women underwent the evaluation of results of mesh implantation within a 24 to 36 months follow-up. Pre-operatively, patients were examined under standardized conditions. Postoperatively we analyzed the following: standardized interview and examination as well as pelvic floor ultrasound: 2D with a transvaginal probe and 4D with an abdominal probe.

Results: There was one case of intraoperative bladder damage noticed and repaired followed with NAZCA implantation. In 2 cases vaginal erosion was found that healed successfully after re-operation. In 3 cases hematomas were observed but resolved spontaneously. After the surgery there was a statistically significant improvement of prolapse in anterior (p < 0.0003) and in central (p < 0.001) compartment. Six women (33.3%) had no stress urinary incontinence symptoms during the control visit but we did not find a statistically significant improvement in SUI symptoms after the procedure. We recorded no case of hypomobile urethra after the surgery. The mesh covered > 50% of the urethral length in all of the patients.

Conclusions: Mid-term results showed that implantation of NAZCA TC mesh allows to achieve statistically significant im­provement in reducing cystocele coexisting with enterocele in over 65% of patients. A complete cure from stress urinary incontinence was confirmed in 1/3 of patients. NAZCA-TC covered more than 50% of the urethral length, which can possibly have a negative influence on the effectiveness of the suburethral tape.

Abstract

Objectives: It is controversial whether pelvic organ prolapse and stress urinary incontinence (SUI) should be treated simultaneously with a single surgery or separately with two procedures. The pre-pubic four-arm NAZCA-TC® mesh was invented to treat cystocele and SUI with a single procedure. The objective of this study is to analyze short-term results after the implantation of NAZCA-TC mesh.

Material and methods: A total of 18 women underwent the evaluation of results of mesh implantation within a 24 to 36 months follow-up. Pre-operatively, patients were examined under standardized conditions. Postoperatively we analyzed the following: standardized interview and examination as well as pelvic floor ultrasound: 2D with a transvaginal probe and 4D with an abdominal probe.

Results: There was one case of intraoperative bladder damage noticed and repaired followed with NAZCA implantation. In 2 cases vaginal erosion was found that healed successfully after re-operation. In 3 cases hematomas were observed but resolved spontaneously. After the surgery there was a statistically significant improvement of prolapse in anterior (p < 0.0003) and in central (p < 0.001) compartment. Six women (33.3%) had no stress urinary incontinence symptoms during the control visit but we did not find a statistically significant improvement in SUI symptoms after the procedure. We recorded no case of hypomobile urethra after the surgery. The mesh covered > 50% of the urethral length in all of the patients.

Conclusions: Mid-term results showed that implantation of NAZCA TC mesh allows to achieve statistically significant im­provement in reducing cystocele coexisting with enterocele in over 65% of patients. A complete cure from stress urinary incontinence was confirmed in 1/3 of patients. NAZCA-TC covered more than 50% of the urethral length, which can possibly have a negative influence on the effectiveness of the suburethral tape.

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Keywords

cystocele, stress urinary incontinence, prepubic four-arm transvaginal mesh, pelvic floor ultrasound, PFS-TV, transvaginal probe

About this article
Title

The effectiveness of a pre-pubic four-arm NAZCA-TC mesh in treating cystocele and stress urinary incontinence simultaneously — results controlled with a pelvic floor ultrasound. A preliminary study

Journal

Ginekologia Polska

Issue

Vol 88, No 11 (2017)

Pages

579-584

Published online

2017-12-05

DOI

10.5603/GP.a2017.0105

Pubmed

29303210

Bibliographic record

Ginekol Pol 2017;88(11):579-584.

Keywords

cystocele
stress urinary incontinence
prepubic four-arm transvaginal mesh
pelvic floor ultrasound
PFS-TV
transvaginal probe

Authors

Edyta Wlaźlak
Tomasz Kluz
Andrzej Wróbel
Magda Krzycka
Grzegorz Surkont

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