Is Posterior Transvaginal Mesh Surgery Using PTFE Mesh ORIHIME Effective and Safe for Advanced Posterior Vaginal Prolapse?

Abstract

Objectives: To examine the efficacy and safety of posterior tension-free vaginal mesh (TVM-P) surgery using polytetrafluoroethylene (PTFE) mesh (ORIHIME) for advanced posterior vaginal prolapse.

Methods: A retrospective cohort study was conducted involving patients who underwent TVM-P surgery with PTFE mesh for pelvic organ prolapse quantification stage III or IV posterior vaginal prolapse between December 2018 and March 2023. All patients were followed for a minimum of 1 year postoperatively. The primary outcome was the recurrence rate in the operated compartment. Secondary outcomes comprised recurrence in other pelvic compartments, mesh-related complications, and an analysis of risk factors for recurrence.

Results: Seventy-one patients underwent TVM-P surgery during the study period. The recurrence rate in the operated compartment was 4.2%, while the overall recurrence rate was 18.3%. Eleven cases of recurrence occurred within the first year; 13 cases were observed within 3 years postsurgery. Patients who experienced recurrence in other compartments had a significantly higher incidence of preoperative Ba point score ≥ -1 versus the nonrecurrence group. Preoperative Ba point score ≥ -1 was associated with a higher risk of recurrence in other compartments (crude odds ratio: 4.17, 95% confidence interval: 1.03-26.7; adjusted odds ratio: 2.58, 95% confidence interval: 0.56-11.8).

Conclusions: The recurrence rate in the operated compartment following TVM-P surgery for advanced rectoceles or enteroceles was 4.2%. These findings suggest that TVM-P surgery using PTFE mesh may be an effective surgical option for treating severe posterior vaginal pelvic organ prolapse.