Long-term results of cystocele repair using vaginal mesh

BACKGROUND: Pelvic organ prolapse is a prominent global health issue, impacting up to 50% of women who have given birth. The anterior vaginal wall is the most typically affected anatomical region for hernia development. Several surgical techniques have been recorded for the repair of cystocele in women, either with or without the use of vaginal mesh. These techniques are commonly associated with the effectiveness and safety of placing synthetic mesh during hernia repair. The purpose of this study is to examine the immediate and long-term complications of transvaginal mesh placement in seven cases of women with cystocele treated in our department.METHODS: Between January 1, 2022 and January 6, 2024, our team implanted seven synthetic vaginal meshes (Calistar S©; Promedon, Argentina) in female patients diagnosed with cystocele. The medical records of these seven women who had surgical correction for cystocele using a synthetic mesh were examined prospectively. The records included demographic information of the patients, clinical indications, details of the surgical method employed, as well as postoperative outcomes and complications. Patient follow-up was conducted for an average duration of 18 months post-surgery.RESULTS: All 7 patients reported relief of cystocele symptoms during the initial surgical assessment at 6 weeks. There were no major issues observed immediately after the surgery, such as the requirement for blood transfusion, mesh perforation (as mentioned in the 2019 FDA warning), or soft tissue infections. However, two patients exhibited slight pain in the vicinity of the mesh, which was alleviated using conservative methods. There were no instances of cystocele recurrence among the patients during the follow-up period.CONCLUSIONS: Despite the FDA’s cautious approach, the utilization of synthetic mesh for cystocele repair seems to be a reliable and secure technique, demonstrating a low incidence of complications and producing excellent outcomes. Based on our expertise, the transvaginal technique has not shown any notable immediate or long-term issues, namely no cases of erosion of the synthetic mesh or infection of the surrounding tissue.