Abstract
Objective
The aim of this study was to compare the surgical, anatomical, and functional outcomes
of sacrocolpopexy (SCP) using polyvinylidene fluoride (PVDF) mesh versus SCP using
the standard polypropylene (PP) mesh.
Study design
This was a retrospective single centre case-control study including female patients
who underwent laparoscopic or abdominal SCP for POP with either PP (Cousin Biotech®) or PVDF (DynaMesh®-PRS) mesh between March 2005 and May 2015. Anatomical outcomes were assessed by the
Pelvic Organ Prolapse Quantification (POP-Q) system. Functional outcomes included
voiding and storage urinary symptoms (VS and SS, respectively), urgency and stress
urinary incontinence (UUI and SUI) and sexual dysfunction (SD). Symptoms and their
impact on patients’ quality of life (QoL) were assessed using validated questionnaires
as Incontinence Impact Questionnaire (IIQ-7), Urinary Distress Inventory (UDI-6) and
Female Sexual Function Index (FSFI). Global patient perception of improvement (PGI-I
questionnaire) and mesh erosion rates were also recorded.
Results
Of the 166 patients enrolled, 136 could be included in the analysis: 73 in the PP
group and 63 in the PVDF group. The mean follow-up was 94± 17.31 months for the PP
and 25.6± 13.8 months for the PVDF group. There were no statistically significant
differences in patient demographics and preoperative clinical characteristics. Postoperative
anatomical correction were not significantly different between the two groups. The
PVDF group showed superior results in term of storage symptoms (PVDF = 0% versus PP = 8.2%; p = 0.02) and lower rate of sexual dysfunction (PVDF = 0% versus PP = 16,4%; p = 0.001). Only 1 patient in PP group and 2 in PVDF group (p = 0.47) presented a mesh exposure. There was no statistical difference in PGI-I scores
(PP = 1.5 ± 1.0 vs PVDF = 1.8 ± 0.5; p = 0.40).
Conclusions
Our findings suggest that both meshes can be safely and effectively used with good
anatomical outcomes. Interestingly, PVDF use was associated with significantly less
storage symptoms and sexual dysfunction.
Keywords
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Article info
Publication history
Published online: November 21, 2017
Accepted:
November 20,
2017
Received in revised form:
November 12,
2017
Received:
March 11,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
