Pelvic Organ Prolapse Repair with Mesh: Description of Surgical Technique Using the Surelift^® Anterior Repair System

Abstract

<b><i>Introduction:</i></b> Although the use of transvaginal mesh (TVM) in the repair of pelvic organ prolapse (POP) has been restricted, there are still some cases in which TVM may be the most appropriate approach. The TVM Surelift® anterior repair surgical technique has not been described previously. <b><i>Objective:</i></b> The aim of this study was to describe the surgical technique and to report our preliminary results regarding efficacy and complications. <b><i>Methods:</i></b> A step-by-step description of surgical technique is presented. A descriptive retrospective analysis was performed to evaluate our preliminary results in 17 women who underwent POP repair using the Surelift® anterior repair system in our department between 2014 and 2017. TVM was offered to patients with symptomatic apical (primary or recurrent) or recurrent anterior POP stage ≥2. POP recurrence was classified as asymptomatic anatomic or symptomatic. Patients rated satisfaction with surgery on a scale from 0 to 10. Complications during follow-up were classified according to the International Urogynecological Association/International Continence Society recommendations. <b><i>Results:</i></b> Median (IQR) follow-up was 19.9 months (24.8). Two (11.8%) anatomic recurrences were identified, both symptomatic, but neither required further surgery. No cases of pelvic pain, dyspareunia, voiding, or defecatory dysfunction were detected. Two (11.8%) patients presented a <1-cm vaginal mesh exposure (2AaT3S2) requiring partial mesh removal through a vaginal approach. At the end of follow-up, median satisfaction (IQR) with the surgery was 9 (3.1). <b><i>Conclusion:</i></b> The Surelift® anterior repair system is effective in correcting apical or recurrent anterior POP, with a high patient satisfaction rate. Complications after this surgery are infrequent and are mostly related to vaginal mesh exposure.

Predictors of Clinical Outcome in Women with Pelvic Organ Prolapse Who Underwent Transvaginal Mesh Reconstruction Surgery

“…Despite the Uphold system and the Perigee system are not available currently. However, some similar commercial kits, self-tailored meshes, and autologous fasciae remain in use for transvaginal POP reconstruction [9][10][11][12][13][14][15][16][17][18][19][20][21]. Thus, our results could provide as a guide for perioperative consultation, even in the era of native tissue repair.…”

“…Despite the above systems are not available in the market owing to the FDA warning [8]. However, some self-tailored vaginal mesh [9][10][11][12] and transvaginal mesh kits, such as Calistar system (Promedon, Argentine [13,14], Surelift system (Neomedic International, Terrassa, Spain [15]), Pelvimesh system (Herniamehs, Italy [16]), and Seratom ® PA system (Seratex ® PA B2 type, Serag-Wiessner KG, Naila, Germany [17]) are still in use. In the era of native tissue repair, autologous rectus fascia or fascia lata are used for transobturator or sacrospinous fixation [18][19][20][21].…”

Effect of anterior vaginal wall prolapse repair by modified transvaginal mesh surgery: a retrospective cohort study

“…There are some similarities between M-TVM and The Surelift system, which reported as a surgical mesh kit and comprised a mono lament polypropylene mesh with 6 adjustable xation points to correct anterior and apical prolapse [24]. The existing literature on the outcomes of Surelift remains extremely limited.…”

Trans-vaginal mesh repair improves bladder compliance in pelvic organ prolapse patients with voiding dysfunctions: A retrospective cohort study

“…Trans-vaginal mesh (TVM), which aims to correct anatomical abnormalities and thereby restore pelvic floor function 8 , is a minimally invasive therapy for POP 9 . Though, in 2016, USA Food and Drug Administration issued a notification concerning the long-term safety of the TVM repair 10 , some TVM kits 11,12,13 are so far viable options for treating POP because they offer a successful anatomical reconstruction and satisfied objective outcomes 14 . Nevertheless, the objective outcome of TVM on the storage function of the bladder, particularly the compliance, has been scarcely investigated.…”