Mid-term results of pelvic organ prolapse repair using a transvaginal mesh: the experience in Sherbooke, Quebec

Abstract

Objective: The objective was to report our experience on the implantation of the Prolift system since 2005. Methods: Fifty-six patients were operated on between July 2005 and August 2008 by 1 surgeon. The patients were implanted with the transvaginal mesh, the Prolift system, for the treatment of recurrent or high-grade (Baden-Walker stage III or IV) multiple compartment pelvic organ prolapse (POP) associated with symptoms. A concomitant anti-incontinence surgery was performed in 38 patients (68%). Results: The population had a mean age of 68 (range 46-88), a body mass index of 27 (range 21-40) and a parity average of 3 (range 1-16). Previous POP repair had been performed in 17 patients (30%) and a hysterectomy in 43 (77%). The operating room time was on average 98 minutes (range 70-135), blood loss 81 mL (range 50-300) and hospital stay 3 days (range 1-10). With a median follow-up of 21 months, we found that the cure rate for POP was 91% (48/53) and the reoperation rate was 8% (4/53). Perioperative complications included 1 rectal laceration and 1 prolonged bleeding. Short-term postoperative complications included 10 episodes of transient urinary retention that required immediate tape release in 4 patients. Long-term complications included 5 POP recurrences, 2 low grade and 3 high grade. Conclusion:The Prolift system appears to be a relatively safe and effective alternative to conventional surgeries for the treatment of recurrent or high-grade multiple compartment POP, because of a high mid-term cure rate and a satisfactory complication profile. However, long-term follow-up is still needed to confirm these results.

Anatomical and Functional Outcomes of Prolift Transvaginal Mesh for Treatment of Pelvic Organ Prolapse

“…Various abdominal and vaginal surgical approaches have been introduced in the past several decades. However, conventional surgical treatments have high recurrence rates of up to 58%, and 20–30% of patients require reoperation for recurrence within 5 years . As a result, a number of synthetic meshes have been designed to reduce recurrence and complication rates in recent years.…”

Predictors of Outcome after Transvaginal Mesh for Pelvic Organ Prolapse

“…Sanses and colleagues in comparing short-term outcomes of vaginal mesh repair to abdominal sacral colpopexy for management of apical prolapse reported an anatomic cure rate of 98.8% for vaginal mesh repair and 99.3% with abdominal sacral colpopexy at three to six months follow-up [3]. A retrospective study of 56 patients who underwent Prolift ® vaginal mesh procedures reported a cure rate of 91% at 21 months follow-up [11], and another series of 60 patients with median follow-up of 29 months reported success rate of 85% with 15% rate of mesh exposure [6]. Others have reported rates of mesh exposure between 1% and 25% [12][13][14].…”

Use of vaginal mesh for pelvic organ prolapse repair: a literature review

“…In 11 non-randomized studies (623 patients), nine of which using NAS meshes, no post-surgical infection was detected [33,[36][37][38][39][40][41][42][43][44][45]. Six studies with NAS meshes reported post-surgical hyperthermia, meaning 3.15% out of 755 cases [46][47][48][49][50][51]. Other frequent infections were urinary, low or high (13 studies, 1,899 patients, mean frequency 5.8%), and infection of the surgical site (nine studies, 1,287 patients, mean frequency 2%).…”