Korean J Urol.  2008 Jul;49(7):616-621.

A Comparison of Traditional Anterior Colporrhaphy and Cystocele Repair with Monofilament Polypropylene Mesh Repair (Gynemesh PSTM)

  • 1Department of Urology, College of Medicine, Hallym University, Seoul, Korea. stcho@hallym.or.kr


PURPOSE: Traditional anterior colporrhaphy repair can have a high recurrence rate. Therefore, the use of synthetic mesh to reinforce the anterior vaginal wall support has been proposed to prevent recurrence. The objective of our study was to compare the anatomic recurrence rates in patients that underwent the traditional anterior colporrhaphy with patients who add a monofilament polypropylene mesh repair(Gynemesh PSTM).
We reviewed the charts of patients who underwent transvaginal cystocele repair between January 2003 and June 2006. All patients had a physical examination and staging of the prolapse; the International Continence Society(ICS) system was used for the staging. Mid urethral sling operations were performed when stress incontinences was an associated feature. An anatomic recurrence was defined as an ICS stage 2 or greater anterior prolapse on the last recorded physical examination. The subjective patient satisfaction was also recorded.
Seventy-one patients were available for study with a mean follow- up of 18.4 months. Thirty-eight patients underwent traditional anterior colporrhaphy, while 33 patients underwent cystocele repair using the monofilament polypropylene mesh(Gynemesh PSTM). Among the 71 patients, 9(12.7%) had recurrence of the cystocele. Based on the type of repair, 21.1%(8/38) of the patients with traditional repair had a recurrence compared to 3.0%(1/33) of the patients with the polypropylene mesh repair(p=0.03). With regard to satisfaction, 76.3%(29/38) of the patients with anterior colporrhaphy and 97.0%(32/33) with the mesh repair were satisfied with the outcome of the surgery(p=0.02). One patient had erosion of the mesh, at the midline, in front of the vaginal scar, at 12 months after the procedure.
Our results suggest that the monofilament polypropylene mesh(Gynemesh PSTM) repairs improved the outcomes of anterior colporrhaphy with regard to the prevention of recurrent cystoceles.


Cystocele; Polypropylene mesh; Surgery

MeSH Terms

Patient Satisfaction
Physical Examination
Suburethral Slings


1.Norton P., Boyd C., Deak S. Abnormal collagen ratios in women with genitourinary prolapse. Neurourol Urodyn. 1992. 11:2–4.
2.Weber AM., Walters MD., Piedmonte MR., Ballard LA. Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol. 2001. 185:1299–304.
3.Birch C., Fynes MM. The role of synthetic and biological protheses in reconstructive pelvic floor surgery. Curr Opin Obstet Gynecol. 2002. 14:527–35.
4.Cervigni M., Natale F., La Penna C., Panei M., Mako A. Transvaginal cystocele repair with polypropylene mesh using a tension-free technique. Int Urogynecol J Pelvic Floor Dys-funct. 2008. 19:489–96.
5.Weber AM., Abrams P., Brubaker L., Cundiff G., Davis G., Dmochowski RR, et al. The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct. 2001. 12:178–86.
6.Paraiso MF., Ballard LA., Walters MD., Lee JC., Mitchinson AR. Pelvic support defects and visceral and sexual function in women with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol. 1996. 175:1423–31.
7.Olsen AL., Smith VJ., Bergstrom JO., Colling JC., Clark AL. Epidemiology of surgically managed pelvic organ prolapse and incontinence. Obstet Gynecol. 1997. 89:501–6.
8.Birch C. The use of prosthetics in pelvic reconstructive surgery. Best Pract Res Clin Obstet Gynaecol. 2005. 19:979–91.
9.Boreham MK., Wai CY., Miller RT., Schaffer JI., Word RA. Morphometric analysis of smooth muscle in the anterior vaginal wall of women with pelvic organ prolapse. Am J Obstet Gynecol. 2002. 187:56–63.
10.Maher C., Baessler K. Surgical management of anterior vaginal wall prolapse: an evidencebased literature review. Int Uro-gynecol J Pelvic Floor Dysfunct. 2006. 17:195–201.
11.Julian TM. The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol. 1996. 175:1472–5.
12.Flood CG., Drutz HP., Waja L. Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J Pelvic Floor Dysfunct. 1998. 9:200–4.
13.Sand PK., Koduri S., Lobel RW., Winkler HA., Tomezsko J., Culligan PJ, et al. Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol. 2001. 184:1357–62.
14.de Tayrac R., Deffieux X., Gervaise A., Chauveaud-Lambling A., Fernandez H. Long-term anatomical and functional assessment of trans-vaginal cystocele repair using a tension-free polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct. 2006. 17:483–8.
15.Hiltunen R., Nieminen K., Takala T., Heiskanen E., Merikari M., Niemi K, et al. Low-weight polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol. 2007. 110:455–62.
16.Choi YS., Choo MS., Lee KS. Efficacy and safety of cystocele repair reinforced with a monofilament polypropylene mesh. Korean J Urol. 2006. 47:640–4.
17.Jung HJ., Jeon MJ., Chung DJ., Park JH., Kim SK., Kim JW, et al. Comparison of anterior repair, anterior repair with prolene mesh and internal anterior repair for surgical treatment of the central type of anterior vaginal wall defects. Korean J Obstet Gynecol. 2007. 50:329–36.
18.Collinet P., Belot F., Debodinance P., Ha Duc E., Lucot JP., Cosson M. Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct. 2006. 17:315–20.
19.Kammerer-Doak DN., Rogers RG., Bellar B. Vaginal erosion of cadaveric fascia lata following abdominal sacrocolpopexy and suburethral sling urethropexy. Int Urogynecol J Pelvic Floor Dysfunct. 2002. 13:106–9.
20.Kim HS., Choi S. Mid-term results and complications of posterior intravaginal slingplasty for patients with uterine and vaginal vault prolapse. Korean J. 2007. 48:971–5.
21.Gauruder-Burmester A., Koutouzidou P., Rohne J., Gronewold M., Tunn R. Follow-up after polypropylene mesh repair of anterior and posterior compartments in patients with recurrent prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2007. 18:1059–64.
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