Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device

Abstract

These results indicate this non-anchored mesh repair is a safe and effective treatment for women with symptomatic vaginal prolapse in the medium term.

Sexual activity and quality of life in Japanese pelvic organ prolapse patients after transvaginal mesh surgery

“…In several studies, it was reported that the majority of patients who were not sexually active before POP repair did not resume their sex lives after POP surgery . In our study, the percentage of patients who responded to the FSFI questionnaire and were sexually active did not change after the TVM surgery ( P = 0.8429); however, of the 13 patients who were sexually active at the baseline, 7 patients (53.8%) continued their sex lives, and 6 patients (46.2%) stopped having sex.…”

“…Among the six patients who suffered recurrence, two patients (0.8%) underwent reoperations within 12 months. In terms of postoperative complications, the extrusion of the mesh through the vaginal wall was detected in five patients (2.1%), and surgical intervention was needed in only one patient (0.4%), which was superior to the results reported in the recent Cochrane review (11.4% and 6.8%, respectively) . These favorable outcomes might have been due to the TVM procedure employed in Japan, that is, the usage of a hand‐cut mesh for each patient.…”

Factors that affect outcomes of prolapse repair using single‐incision vaginal mesh procedures

“…There seems to be a surgical learning cure for Elevate but not for Prosima repairs. Considering the consistently lower cure rates of Prosima compared to other vaginal mesh procedures with anchorage and our results, we suggest the Prosima procedure, using non‐anchored meshes, may have a fundamental limitation for improving anatomic outcomes with more surgical experience. Long et al also found a similar learning curve in trocar‐guided vaginal mesh procedures that after the initial 50 cases, failure was rare …”

“…The trocar-free SIVM procedures may, therefore, shorten operating time, reduce nerve and vessels injury, and decrease pelvic pain and dyspareunia rates. 6,7 However, there are variations in reported cure rates from case series [6][7][8][9][10] or comparative studies [11][12][13] at a short to medium term follow-up.…”

“…Two SIVM procedures, that is, the Prosima system (Ethicon, Somerville, NJ) 6,8,9 and the Elevate system (American Medical Systems, Minnetonka, MN), 7,10-13 have been mentioned most frequently in the literature with objective cure rates of 69.1-84% and 90-98%, respectively. [6][7][8][9][10][11][12][13] These two procedures differ in mesh fabrication (original vs lightweight) and methods of implantation (nonanchorage vs anchorage) that may affect treatment outcomes. In this study, we aim to evaluate and compare the safety and effectiveness of the two SIVM procedures.…”