Clinical Outcomes and Urodynamic Effects of Tailored Transvaginal Mesh Surgery for Pelvic Organ Prolapse

Figure 2

Components of the posterior transvaginal tailored mesh surgical procedure. (a) Separation of the rectum until the posterior fornix of the cervix is separated from the posterior vagina. (b) Drawing of the grasshopper body with its six arms and the polypropylene mesh (Gynemesh, 15 × 10 cm). (c) Custom-tailored mesh with the central grasshopper body and six arms. (d) Fixation of the head of the grasshopper-shaped portion to the posterior upper cervix and the insertion of the P1 and P2 arms into the bilateral uterosacral space without fixation. The P3 and P4 arms have already been inserted through the buttocks. (e) Complete positioning of the body and arms of the mesh covering the entire upper surface of the rectum without tension, with the exception of the P1 and P2 arms, which are to be inserted into the bilateral uterosacral spaces without fixation. The redundant tail part of the mesh will be trimmed to an appropriate length.

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