Transvaginal pelvic floor reconstruction with a polipropilene mesh

Purpose A new method to support female prolapsed pelvic organs is presented. It employs a non-absorbable mesh cut in a particular hammock shape. The approach is transvagioal and the front of the hammock is fixed to the bladder neck, the rear to the uterine cervix, and the sides to the endopelvic fascia. Materials and Methods From January to December 1996 nineteen patients were treated with this method: nine (47.3%) had a III degree cystocele, seven (36.8%) had a II degree cystocele, three (15.7%) a I degree cystocele. Twelve had a combination of cystocele, vaginal vault prolapse and rectocele and three of this last group also had enterocele. Cystoceles were classified according to SEAPI-QMM classification and the other anatomical disorders according to Beecham classification. Fourteen patients (73.6%) revealed different degrees of incontinence, three a 3rd, three a 2nd, and eight a 1st degree according to the to SEAPI-QMM classification. All patients had a radiological and urodynamic evaluation. Results Maximum follow-up period was twelve months, minimum four months with a mean of nine. All incontinence patients became subjectively dry after the operation, all the others were cured of their pelvic organ descensus as demostrated by their imaging tests. Conclusions This operation is simple and easy to perform, the vaginal approach minimizes surgical trauma and its application is broad, including all degrees of cystocele, genito-urinary prolapse and vaginal vault prolapse, with or without incontinence.