Double sling with polyvinylidene fluoride implant: Evaluation of functional and anatomical outcomes of concomitant retropubic sling and anterior vaginal wall prolapse repair

Abstract

Background: Several kinds of procedures have been introduced for surgical rectification of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) using various ynthetic meshes such as polypropylene (PP) material. Polyvinylidene fluoride (PVDF) meshes have been proven to have higher biocompatibility, lower morbidity, and also less inflammatory and fibrotic reactions in comparison with PP meshes. Here, we intend to report a 2?year follow?up report of patients who had undergone transvaginal surgery using PVDF meshes to rectify POP and concomitant SUI.

Materials and Methods: Between August 2015 and May 2024, 38 peri? or postmenopausal women with high?grade anterior compartment prolapse and concomitant SUI, who were nonresponsive to conservative management, were scheduled and underwent double?sling (anterior retropubic mid?urethral sling and posterior  ransobturator tape) surgery using a four?arm PVDF mesh. The patients were followed up for at least 24 months.

Results: Thirty?eight patients were enrolled in the study and followed for an average of 5.7 years. A statistically significant subjective improvement was observed after 2 years (P = 0.029) regarding the vaginal symptom score and SUI. Two?year outcomes for all these patients revealed an 83% anatomical success rate. Two mesh exposures were observed (5.2%) after 4 years. No other severe mesh?related complications were registered. Conclusion: Double sling with PVDF implant is a safe and convenient procedure for the selected women with high?grade anterior compartment prolapse and symptomatic
concomitant stress urine incontinence (SUI).