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Surgery Research and Practice
Volume 2015, Article ID 303679, 8 pages
http://dx.doi.org/10.1155/2015/303679
Clinical Study

The Use of Tutomesh for a Tension-Free and Tridimensional Repair of Uterovaginal and Vaginal Vault Prolapse: Preliminary Report

1Divisione di Ostetricia e Ginecologia, ASL 4 Chiavarese, Ospedale Rivoli, 16033 Lavagna, Italy
2Dipartimento Materno Infantile, Ostetricia e Ginecologia, ASL 5 Spezzino, 19100 La Spezia, Italy

Received 22 January 2015; Revised 3 July 2015; Accepted 2 August 2015

Academic Editor: Eelco de Bree

Copyright © 2015 Danilo Dodero and Luca Bernardini. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To evaluate efficacy in terms of vaginal capacity, coital function, and recurrence prevention of a new biological mesh of bovine pericardium (Tutomesh) in the repair of severe POP. Methods. Thirty cases of patients suffering from stage III uterine or apical prolapse undergone surgical repair by means of a modified sacrospinous ligament suspension combined with mesh attachment to both the cardinal ligaments, posterior and anterior colporrhaphy, and perineal body fixation. The mesh was replaced inside the pelvis with the goal of reconstructing the tridimensional fascial disposition of the structures sustaining the correct axis of vagina. Follow-up was done at 12 months with POPIQ analysis. Results. One total mesh failure occurred early after surgery due to marked deficiency of anatomy. Two cystoceles were observed at 12 months in two patients treated for apical prolapse where anterior repair was not performed. Two other patients developed a de novo SUI at 12 months. No reported abnormalities of coital function or dyspareunia were ever found after surgery. Conclusions. It is possible that the utilization of a tension-free and tridimensional placement of Tutomesh might favor a more physiologic reconstruction of the vaginal axis as compared with traditional sacrospinous ligament suspension.