The Tissue Fixation System provides a new structural method for cystocoele repair: A preliminary report

Background: A new reconstruction principle that uses tensioned tapes instead of large mesh is described for cystocoele repair. Aim: To apply this method to patients with central, paravaginal and cervical ring defects. Methods: Ninety patients, mean age 63 years (29-83) and mean weight 73 kg (52-117 kg), underwent cystocoele repair using the Tissue Fixation System (TFS). Tapes were applied as a retro-obturator U-sling (n = 29), transversely between both arcus tendineus fascia pelvis (ATFP) ligaments (n = 45), along the path of the cardinal ligament in patients with cervical ring defects (n = 12), and longitudinally along the ATFP ligament (n = 4). Results: At mean eight months review (three to 15 months), two failures were reported. There was one haematoma that drained spontaneously at seven days, and there were no erosions. Mean hospital stay was one a half days for the Australian group (one to seven days) and five days (four to eight days) for the European group. After using single U-sling, one patient required intermittent catheterisation for seven days before she could pass urine freely. In one patient the bladder was perforated during dissection laterally towards the ATFP; the perforation was successfully repaired. Conclusions: The tensioned tape operation is simple and accurate, and appears to work well in the short term. Longer-term studies are required.