Lifetime Risk of Undergoing Surgery for Pelvic Organ Prolapse

Smith, Fiona; Holman, C. DʼArcy J.; Moorin, Rachael; Tsokos, Nicolas

doi:10.1097/aog.0b013e3181f73729

Cited by 688 publications

(394 citation statements)

References 23 publications

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“…Recent Australian data show that the lifetime risk of a woman having surgical treatment for prolapse in this country is 19%. 1 Prolapse is likely to become more prevalent as our population ages, so a review of new evidence regarding the aetiology of this condition is timely.…”

Section: Introductionmentioning

confidence: 99%

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Lim

Khoo

Wong

et al. 2014

Aust NZ J Obst Gynaeco

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Gynaecologists are becoming increasingly aware that women with a family history of prolapse are at an increased risk of prolapse refractory to treatment. In the past five years, several genetic mutations have been shown to correlate with increased prolapse susceptibility. These mutations can result in disordered collagen metabolism, which weaken the fascial support of the pelvic organs. This review examines the contemporary evidence regarding the role of collagen in prolapse.

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Section: Introductionmentioning

confidence: 99%

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Lim

Khoo

Wong

et al. 2014

Aust NZ J Obst Gynaeco

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“…Most of these will be early stage/mild prolapses and cause no symptoms [4]. Although only 3-6% of these cases will have any symptoms, the lifetime risk of a women in the general population undergoing a POP surgery has been reported to be 20% (excluding hysterectomy cases) [3]. As the population ages the prevalence of POP is estimated to increase substantially by 46% between 2010 and 2050 [5].…”

Section: Introductionmentioning

confidence: 99%

“…Some degree of POP is seen in up to 30-76% of women who have their routine gynaecological examinations [3]. Most of these will be early stage/mild prolapses and cause no symptoms [4].…”

Section: Introductionmentioning

confidence: 99%

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

Mangır¹,

Chapple²,

MacNeil³

2018

Pelvic Floor Disorders

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Synthetic materials have long been used to provide structural support when surgically repairing pelvic organ prolapse (POP). The most widely used synthetic material is a mesh made of polypropylene (PPL). The use of mesh is intended to improve cure rates and prevent recurrences after POP surgery -however as more mesh materials have been implanted, it has become apparent that serious complications can occur in up to 30% of women, particularly when the mesh is implanted transvaginally. Over the years many different mesh kits have been marketed and used in the treatment of POP however polypropylene mesh was never designed or tested for use in pelvic floor. Instead it was approved for clinical use based on its biocompatibility and success in abdominal hernia repairs. It is now known that PPL meshes are neither compliant with the mechanical forces in the pelvic floor nor do they integrate well into paravaginal tissues. Better materials developed specifically for use in pelvic floor are urgently needed. The aim of this chapter is to define the requirements of an ideal mesh in terms of its material properties and to summarize the ongoing research on developing the next generation pelvic floor repair materials.

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“…2 In Western Australia, the estimated lifetime risk of a patient requiring reconstructive surgery is as high as 19%. 3 Amongst the different types of POP, cystocele is the most common 4 and the most challenging to repair, with recurrence rates of about 30-50% following traditional native tissue reconstruction. 5,6 In the last nine years, anterior compartment mesh kits have become popular due to a higher anatomical success rate, when compared with native tissue repair.…”

Section: Introductionmentioning

confidence: 99%

A comparison of two different mesh kit systems for anterior compartment prolapse repair

Wong

Shek

Rane

et al. 2014

Aust NZ J Obst Gynaeco

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Background and Aim: Mesh reinforcement is considered an effective method for anterior compartment prolapse repair. Two common methods of mesh reinforcement involve either transobturator fixation (eg Perigee TM ) or lateral and apical anchoring (eg Anterior Elevate TM ). The aim of this study was to assess subjective and objective outcomes after Anterior Elevate and Perigee mesh kit surgery. Materials and Methods: This was a surgical audit of patients after anterior colporrhaphy (AC) with mesh reinforcement, undertaken at three tertiary urogynaecological centres. All patients were assessed for prolapse recurrence, which was defined as either (i) symptoms of prolapse (vaginal lump/dragging), (ii) ICS POPQ ≥ Stage 2, or (iii) bladder descent ≥10 mm below the symphysis pubis on transperineal ultrasound. Mesh co-ordinates and organ descent on Valsalva were determined relative to the inferior symphyseal margin. Results: Two hundred and twenty-nine patients with anterior compartment mesh (138 Perigee, 91 Elevate) were assessed at a median follow-up of 1.09 years (IQR 0.65-2.01). On assessment, 24% (n = 55) had symptoms of prolapse recurrence, 46% (n = 106) had a clinical recurrence, and 41% (n = 95) a recurrent cystocele sonographically. All objective results favoured the Perigee group. The superiority of the Perigee kit remained highly significant (P < 0.0001 for all clinical and ultrasound measures of prolapse recurrence) on multivariate analysis. Conclusions: This retrospective analysis suggests that apical anchoring such as Anterior Elevate mesh system does not necessarily confer an advantage over the original transobturator mesh fixation technique for anterior compartment reconstruction.

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Lifetime Risk of Undergoing Surgery for Pelvic Organ Prolapse

Abstract: II.

Cited by 688 publications

References 23 publications

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Recent studies of genetic dysfunction in pelvic organ prolapse: The role of collagen defects

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

A comparison of two different mesh kit systems for anterior compartment prolapse repair

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