Efficacy of Transvaginal Surgery Using an ORIHIME Mesh With Wider Arms and Adjusted Length

Introduction: Transvaginal mesh surgery (TVM) is an effective treatment measure for pelvic organ prolapse(POP). However, the ORIHIME mesh (Kono Seisakusho, Japan, Tokyo), which has the disadvantage of pooradherence to tissues, is currently the only product available for this procedure. Our research team haspreviously developed a modified ORIHIME mesh with wider arms with the aim of minimizing the risk of POPrecurrence. Additionally, the length of the mesh behind the anterior vaginal wall has been adjusted toprevent urinary incontinence. The current study aims to examine the efficacy of this modified mesh inminimizing postoperative complications in patients undergoing uphold-type TVM. Methods: The data of 84 patients who underwent TVM using ORIHIME at our hospital since July 2019 wereretrospectively analyzed. The patients were divided into three groups as follows: (a) normal arms (NA; armwidth < 6 cm; n = 29 cases); (b) wide arms without length adjustment (WA and LA (-); arm width > 6 cm; n =27 cases); and (c) wide arms with length adjustment (WA and LA (+); n = 28 cases). Data were collected usingvarious questionnaires, and the residual urine volume was measured before and after surgery. Additionally,the 60-minute pad test was performed where possible, and the recurrence and complication rates wererecorded. Results: The incidence of mesh exposure and urinary incontinence in daily life tended to be lower in the WAand LA (+) groups, although this difference was not statistically significant. The one-year postoperative POPrecurrence rate, residual urine volume, International Prostate Symptom Score (IPSS), Overactive BladderSymptom Score (OABSS), and the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF) score were significantly lower in the WA and LA (+) groups compared to the other groups. Conclusion: Uphold-type TVM using the modified ORIHIME mesh with wider arms and adjusted length wasassociated with better postoperative treatment outcomes compared to TVM using the traditional ORIHIMEmesh