Colpocleisis for recurrent pelvic organ prolapse after tension-free vaginal mesh repair: a case report

TL;DR

This case report describes a patient with recurrent pelvic organ prolapse after a mesh-based surgery, treated successfully with vaginal closure surgery.

Contribution

The case highlights the potential for recurrent prolapse after tension-free vaginal mesh repair and the viability of colpocleisis as a management option.

Findings

Recurrent posterior vaginal wall prolapse can occur after tension-free vaginal mesh repair for anterior wall prolapse.

LeFort colpocleisis is a safe and effective treatment option when conservative management is not feasible.

Abstract

Tension-free vaginal mesh repair surgery (TVM) has decreased due to complications related to mesh use and the lack of superiority compared to native tissue repair (NTR). In japan it is still performed as a treatment for pelvic organ prolapse (POP). However, recurrent prolapse after TVM does occur, necessitating appropriate management. The patient was underwent TVM-A surgery at another hospital 12 years ago for cystocele. POP-Q stage II rectocele was observed, and the LeFort colpocleisis was performed. Although TVM surgery is effective via the vaginal approach, recurrent posterior vaginal wall prolapse may occur over time, as seen in this case, even in patients who had single-mesh procedures for anterior vaginal wall repair. When conservative treatment is difficult, vaginal closure surgery, a traditional approach, can be safely performed.

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