[The preliminary evaluation of surgical treatment of pelvic organ prolapse with polypropylene mesh by double transobturator approch technique (double TOT)].
OBJECTIVES: The aim of this study was to evaluate preliminary results of a new, simple surgical technique with the use of polypropylene mesh (double TOT) used for the treatment of cystocele associated / not associated with urinary incontinence in females. MATERIAL AND METHODS: 19 women, aged 49-76, BMI 24-40, with cystocele associated or not with urinary incontinence, were operated on at the 1st Department of Obstetrics and Gynaecology in Warsaw, using double TOT technique. In this technique, described by Theobald, the trapezoidal polypropylene four-arm vaginal mesh is inserted through the obturator foramens from the outside to the inside and is positioned without tension under the urethra. RESULTS: 9 patients qualified for the operation were grade III in POPQA, 5--grade IV, 4--grade II and one patient grade I. 16 women had additional operations performed beside double TOT. The duration of operations varied from 30 to 135 minutes. No intra-operative complications were observed. There were no complications in short 6 weeks follow-up. CONCLUSIONS: Double Transobturator technique is simple, easy to learn, safe and, at the same time, efficient surgical procedure for the treatment of pelvic organ prolapse and female urinary stress incontinence. The results of longer follow-up on a larger group of operated patients will be more accurate.