Polypropylene Anterior-apical single-incision mesh surgery in women with severe pelvic organ prolapse—a case series at 53 months median period follow-up

Abstract

Objective This study aims to assess the medium-term outcomes of UpholdTM-LITE system for treatment of advanced pelvic organ prolapse (POP). Methods This is a retrospective case series of 53 months follow-up of 123 consecutive patients who underwent UpholdTM-LITE system. Objective outcome measure was the anatomical correction of prolapse with POP-Q ≤ Stage 1. Subjective outcome was patient’s feedback to questions 2 and 3 of POPDI-6. Secondary outcome measures the quality of life, presence of lower urinary tract symptoms and complications. Quality of life is assessed by validated questionnaires on UDI-6, IIQ-7, POPDI-6, and PISQ-12 at 1 and 3 years post-operatively. Results Objective outcome at 1 and 3 years was at 96.7% and 95.4% respectively. The subjective cure was 95.1% and 91.6%. Five-year cumulative cure rate maintained at 87.2%. Secondary outcomes observed improvement on UDI-6, IIQ-7, POPDI-6 and PISQ-12 postoperatively. Bladder outlet obstruction (BOO) improved while De novo urodynamic stress incontinence (USI) increased slightly post surgically. Mesh erosion rate was 0.8%. Conclusion The UpholdTM-LITE system demonstrated good medium term anatomical correction of apical and anterior prolapse, with good subjective cure and improved quality of life. Whilst complication rate was low, a slight increased in De novo USI was observed.