Tension-free vaginal mesh operation for concomitant rectal a
Published in the journal Urology Case Reports, the authors present a case of a patient with pelvic organ prolapse (POP) with concomitant cystocele, uterine prolapse, and rectal prolapse, which was repaired by an anterior and posterior tension-free vaginal mesh (TVM) operation.

An 80-year-old woman who had voiding dysfunction and defecation disorder was referred to the hospital. She had three children through transvaginal delivery, and an unremarkable medical history. Her height, weight, and body mass index were 160 cm, 40 kg, and 15.6 kg/m2, respectively. The gynecological examination revealed cystocele and stage IV uterine prolapse, based on the POP-quantification staging system, and grade V rectal prolapse, based on the Oxford rectal prolapse grading system.

MRI revealed a cyctocele and uterine prolapse, and defecography revealed no rectocele. The authors chose surgical treatment for patients with POP whose stage, based on the POP-quantification staging system, was stage II with symptoms or higher than stage II.

Her rectal prolapse was simultaneously repositioned when her uterine prolapse was pushed back manually; therefore, we believed that an anterior and posterior TVM operation would be useful for correcting the uterine prolapse and the rectal prolapse.

During the surgery, the uterine prolapse and rectal prolapse were manually repositioned in advance. First, a posterior TVM operation was conducted. An anterior TVM operation was then conducted conventionally with the patient under general anesthesia.

The cystocele, uterine prolapse, and rectal prolapse were repaired. The postoperative period was uneventful. During 1 year of follow up after the anterior and posterior TVM, the cystocele, uterine prolapse, or rectal prolapse has not recurred.

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Dr. n●●●●l v●●●●●●a and 2 other likes this
Dr. S●●●●●v S●●●●●1
Dr. S●●●●●v S●●●●●1 Obstetrics and Gynaecology
So conventional anterior and posterior repairs were combined with TVM repair !
Oct 11, 2018Like