Evidence map›Paper›PMID 41811607›Full record

ArticleJournal of ultrasound2026

The risk factors of anatomical cystocele recurrence: the hiatal area and the lowest vaginal mesh location observed by pelvic floor ultrasound.

Yalin Yang, Yi Lan, Yujie Yang, Fuqin Yang, Yusong Chen, Ya Wang, Lieming Wen

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Article in Journal of ultrasound, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Yalin Yang *Health Management Centre, First Affiliated Hospital to Army Medical University, Chongqing, China.
Yi Lan *Department of Ultrasound Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China.
Yujie YangDepartment of Ultrasound Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China.
Fuqin YangDepartment of Ultrasound Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China.
Yusong ChenDepartment of Ultrasound Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China.
Ya WangDepartment of Ultrasound Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China.
Lieming WenDepartment of Ultrasound Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China. wen_lieming@csu.edu.cn.ORCID http://orcid.org/0000-0003-3283-888X

Funding

Hunan Provincial Natural Science Foundation 2023JJ60504
6 · The paper itself

Abstract

objectivesTo explore the risk factors for the anatomical cystocele recurrence (ACR) after transvaginal mesh (TVM) implantation.

methodsPatients with a TVM between 2015 and 2023 were enrolled. ACR is determined as the bladder descended ≥ 10 mm below the pubic symphysis or a cystocele stage II or higher. The lowest mesh position (LMP) determined by ultrasound corresponded to the caudal mesh end relative to the bladder neck at maximum descent. Positions below the bladder neck were noted as negative values. The hiatal area (HA) was measured using four-dimensional pelvic floor ultrasound. The differences between women with ACR and without were analyzed.

resultsWe enrolled 111 women with a median follow-up of 13 months. Group I included 25 (22.5%) women with ACR. Group II had 86 controls. The median LMP was - 7.0 mm (range - 23 to 18). It was higher in Group I than in Group II (- 3.0 mm vs. - 7.0 mm; p = 0.005). In predicting ACR, LMP had an odds ratio of 1.08 (p = 0.015) and a cutoff of - 3.0 mm (52.3% sensitivity and 72.0% specificity). Multivariate regression analysis revealed odds ratios of 4.3, 3.2, 10.7, and 5.0 (all p < 0.05) for preoperative cystocele stage IV, preoperative HA ≥ 30 cm

conclusionsThe larger the HA, the higher the risk of postoperative cystocele. If the caudal mesh end is located more than 3 mm below the bladder neck, the risk of ACR is 500%.

Indexed as

CystocelePelvic FloorSurgical MeshAdultAgedFemaleHumansMiddle AgedRecurrenceRisk FactorsUltrasonographyVaginaCystocelePelvic floor reconstructionPelvic floor ultrasoundPelvic organ prolapse recurrenceTransvaginal mesh

Identifiers

PMID41811607
PMCPMC13588771

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