Prospective long-term results, complications and risk factors in pelvic organ prolapse treatment with vaginal mesh

Laso-García, I.; Rodríguez-Cabello, Miguel Ángel; Jiménez-Cidre, Miguel Ángel; Orosa-Andrada, Andrea; Carracedo-Calvo, David; Lavalle, Luís López-Fando; Burgos-Revilla, F.J.

doi:10.1016/j.ejogrb.2017.02.005

Cited by 15 publications

(11 citation statements)

References 33 publications

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“…In the short and medium term, our results are similar to the articles published in relation to the success rate of studies with the same device and implantation route (92% in our series vs. 80.3%) [22] and different prosthetic devices but with the same implantation route (91.3%) [35], although its comparison is difficult due to the existence of different follow-up times. In our series, the minimum follow-up time was 6 months, while in studies such as the one published by Ferry et al [22] they only had 3 months of follow-up.…”

Section: Discussionsupporting

confidence: 89%

Surgical Treatment of Pelvic Organ Prolapse

Fernández-Ávila¹,

García-Baquero²,

Claro³

et al. 2022

Pelvic Floor Dysfunction - Symptoms, Causes, and Treatment

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The human being is the only mammal capable of walking and simultaneously maintaining an upright position. This fact, implies somewhat unfavorable repercussions for the pelvic region that must support the weight of the abdominal organs. A prime example of the aforementioned adverse effects of the standing position are pelvic organ prolapses (POP). POP surgery is an increasingly important therapeutic aspect in clinical practice due to the aging of our population, and is increasingly prevalent as a therapeutic option. Surgical techniques can be performed using an abdominal or vaginal approach, depending on the medical history, physical examination, and experience of the surgeon. Laparoscopic sacrocolpopexy is an adequate therapeutic option with a high success rate in 80–100% of cases. However, this technique is not always appropriate, especially for patients who are at high risk for anesthesia, a multi-operated abdomen, or in recurrent prolapse. In these cases, a vaginal approach offers an interesting surgical alternative. In this review, we added our experience with transvaginal single-incision mesh under locoregional anesthesia for correction of female POP. We retrospectively analyzed 78 patients showing a success rate of 92% after more than 12 months of follow up. Transvaginal mesh was developed to maintain the advantage of a vaginal procedure, while reducing the risk of recurrent prolapse compared to native tissue repair and simplifying the surgery compared to sacrocolpopexy.

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Section: Discussionsupporting

confidence: 89%

Surgical Treatment of Pelvic Organ Prolapse

Fernández-Ávila¹,

García-Baquero²,

Claro³

et al. 2022

Pelvic Floor Dysfunction - Symptoms, Causes, and Treatment

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“…Rates of mesh extrusion and pain were taken from cohort studies and were used to estimate the annual probabilities attached to the synthetic mesh repairs . As women continue to develop complications during long‐term follow up, the estimated annual probabilities were applied at each year for the duration of the model.…”

Section: Introductionmentioning

confidence: 99%

Primary surgical management of anterior pelvic organ prolapse: a systematic review, network meta‐analysis and cost‐effectiveness analysis

Slade

Daly

Mavranezouli

et al. 2019

BJOG

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Background Anterior compartment prolapse is the most common pelvic organ prolapse (POP) with a range of surgical treatment options available. Objectives To compare the clinical effectiveness and cost‐effectiveness of surgical treatments for the repair of anterior POP. Methods We conducted a systematic review of randomised controlled trials comparing surgical treatments for women with POP. Network meta‐analysis was possible for anterior POP, same‐site recurrence outcome. A Markov model was used to compare the cost–utility of surgical treatments for the primary repair of anterior POP from a UK National Health Service perspective. Main results We identified 27 eligible trials for the network meta‐analysis involving eight surgical treatments tested on 3194 women. Synthetic mesh was the most effective in preventing recurrence at the same site. There was no evidence to suggest a difference between synthetic non‐absorbable mesh, synthetic partially absorbable mesh, and biological mesh. The cost–utility analysis, which incorporated effectiveness, complications and cost data, found non‐mesh repair to have the highest probability of being cost‐effective. The conclusions were robust to model inputs including effectiveness, costs and utility values. Conclusions Anterior colporrhaphy augmented with mesh appeared to be cost‐ineffective in women requiring primary repair of anterior POP. There is a need for further research on long‐term effectiveness and the safety of mesh products to establish their relative cost‐effectiveness with a greater certainty. Tweetable abstract New study finds mesh cost‐ineffective in women with anterior pelvic organ prolapse.

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“…They are reconstruction procedures for anterior and apical POP without rectal prolapse. 20 Follow-up at 1-year showed that this procedure had a surgical effect similar to traditional pelvic floor reconstruction procedures in anatomical reduction; there were no cases of POP (grade II and above) recurrence, and the objective cure rate was up to 100%. At 12 months after surgery, TVL in the observation group was longer than that in the control group, indicating that the six-arm mesh procedure is superior to traditional mesh procedures in postoperative vaginal extensibility.…”

Section: Discussionmentioning

confidence: 78%

“…Geller et al 24 monitored 160 patients with mesh insertion for 20 months and found that, after surgery, the incidence rates of pelvic pain and dyspareunia were 15.6% and 19%, respectively. As reported in the literature, the incidence rate of discomfort during sexual intercourse after pelvic floor reconstruction is 4% to 20% 20 – 26 by 5-year long-term follow-up; Meyer et al 27 found the rate to be as high as 36%. In our research, the incidence of dyspareunia in the six-arm mesh group was 1.02%, which was significantly lower than that in the traditional group (14.56%; P <0.001).…”

Section: Discussionmentioning

confidence: 93%

<p>Subjective and Objective Evaluation of Total Pelvic Floor Reconstruction with Six-Arm Mesh in Patients with Severe Pelvic Organ Prolapse: A 1-Year Retrospective Study</p>

Zhao

Xia

et al. 2020

TCRM

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Purpose To investigate the effect of total pelvic floor reconstruction with a six-arm mesh in the treatment of pelvic organ prolapse. Patients and Methods This is a retrospective observational cohort study. A total of 368 patients with pelvic organ prolapse underwent pelvic floor reconstruction surgery. Patients were categorized by the type of surgical mesh: 176 patients received a six-arm mesh and 192 patients received an anteroposterior approach mesh. The 1-year effect of the two groups was compared. The Pelvic Floor Distress Inventory Questionnaire (PFDI-20), Colorectal-Anal Distress Inventory (CRADI-8) and the Pelvic Organ Prolapse Quantitation (POP-Q) staging were used for evaluation. The incidence of complications was recorded. A cure standard was registered by a POP-Q score of grade I or below. A P value <0.05 indicates the difference is statistically significant. Results There was no recurrence documented in the patients; the cure rate was 100% in both groups. After surgery, the length of the vagina in the six-arm mesh group was longer than that of the control group at 6 months and 12 months, respectively ( P < 0.05). The six-arm mesh group had lower PFDI-20 and CRADI-8 scores after surgery than those of the control group at 6 and 12 months, respectively ( P < 0.05). Pelvic floor and rectal dysfunction symptom improvement were superior in the six-arm mesh group compared with the control group. After surgery, the Female Sexual Function Inventory (FSFI) score of the six-arm mesh group was superior to that of the control group at 6 and 12 months, respectively ( P < 0.05). The incidence of complications in the six-arm mesh group was lower than that of the control group ( P < 0.05). Conclusion The total pelvic floor reconstruction using six-arm mesh has the same healing rate as anteroposterior approach mesh surgery, and it is better than traditional surgery in improving subjective symptoms and reducing postoperative complications.

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Prospective long-term results, complications and risk factors in pelvic organ prolapse treatment with vaginal mesh

Cited by 15 publications

References 33 publications

Surgical Treatment of Pelvic Organ Prolapse

Surgical Treatment of Pelvic Organ Prolapse

Primary surgical management of anterior pelvic organ prolapse: a systematic review, network meta‐analysis and cost‐effectiveness analysis

<p>Subjective and Objective Evaluation of Total Pelvic Floor Reconstruction with Six-Arm Mesh in Patients with Severe Pelvic Organ Prolapse: A 1-Year Retrospective Study</p>

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