Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Abstract

Objective: To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold TM System. Study design: In this prospective cohort study, women (n = 207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold TM Vaginal Support System. Follow-up for quality of life was performed at 12 months after surgery, and assessed by the PFDI-20, and PFIQ-7, and sexual function by the PISQ-12. We used odds ratios (ORs) with 95% confidence intervals (CIs) for outcome association analyses using logistic regression.Results: At one-year follow-up majority of women experienced an overall postoperative improvement in quality of life (p < 0.001). One year after surgery Uphold TM operation alone increased the risk for prolapse related bother as compared to Uphold TM combined with anterior colporraphy (POP-IQ-7; OR 2.1; 95% CI 1.01-4.3). The frequency of dyspareunia decreased postoperatively (p = 0.004), however, after one-year, overall sexual function deteriorated significantly (p < 0.001). The worsening in sexual function scores was mainly attributed to the partner related domain, whereas the behavioral-emotive and physical domains showed no significant changes. Conclusion: Apical prolapse repair using Uphold TM improved quality of life among our patients but worsened overall sexual function postoperatively. 2016 Elsevier Ireland Ltd. All rights reserved. IntroductionAlthough the restoration of vaginal topography often results in improvements in pelvic organ prolapse symptoms the incongruence between objective and subjective outcomes in pelvic organ prolapse surgery is well established [1][2][3]. As a consequence, the focus of pelvic organ prolapse surgery has pivoted towards patients centered outcomes and quality of life measures, [4-6] rather than simply measuring pelvic anatomy outcomes of surgery.In women after pelvic organ prolapse surgery quality of life measures may entail a variety of domains of which the effects on sexual function has received perhaps the most attention [7]. Nonetheless, it remains unclear how, and to what extent, sexual dysfunction relates to pelvic reconstructive surgery. Some studies suggest that sexual dysfunction is a common sequela after mesh augmented reconstructive surgery [8,9], others suggest that surgery has no effect [10][11][12], or even improve sexual function domains [13,14]. Ambiguous results have also been shown for other quality of life domains in relation pelvic organ prolapse surgery.We have previously reported on the safety and efficacy outcomes and subjective relief of condition specific symptoms after using the Uphold TM Vaginal Support System [15]. In the present study we assessed quality of life and sexual function outcomes following Uphold TM surgery in a prospective cohort of women with apical prolapse and with or without concurrent cystocele.

Clinical evaluation of the Uphold LITE mesh for the surgical treatment of anterior and apical prolapse: A prospective, multicentre trial

“…Previous studies involving the Uphold LITE mesh kit treatment of prolapse have reported a 12‐month success rate of 94% for the apical compartment and 71% for all compartments; the rate of serious complications was 4.3% . Rahkola‐Soisalo et al reported a success rate of 97.5% for the apical compartment and 78% for the anterior compartment at 5‐year follow‐up. The lower success rate in the current study might be explained by the use of a composite endpoint included both anatomic and subjective success plus no reintervention.…”

“…The Uphold LITE mesh kit is a third generation kit comprising a two arm, lightweight polypropylene mesh with a decreased biomaterial load to avoid mesh‐related complications. Some studies reported high success rates with a relatively low rate of complications . Nevertheless, the advantages and disadvantages of transvaginal mesh surgery are still debated and further studies are needed to confirm these results.…”

“…Some studies reported high success rates with a relatively low rate of complications. [7][8][9] Nevertheless, the advantages and disadvantages of transvaginal mesh surgery are still debated and further studies are needed to confirm these results. The aim of this study was to evaluate the success rate, safety, and quality of life (QoL) outcomes of the Uphold LITE mesh in the treatment of anterior and apical prolapse after 12-months follow-up.…”

Health-related quality of life after pelvic organ prolapse surgery in Ethiopia: A 6 month follow-up study

“…The better QoL scores compared to baseline scores were also observed in all the 3 P-QoL components (PC, PSC and PRC) after 6 months. Previous studies in Western countries using P-QoL instrument also con rmed that correction of POP via alloplastic vaginal meshes can signi cantly improve patients' QoL [24,[38][39][40][41][42].…”

The assessment of quality of life and satisfaction with life of patients before and after surgery of an isolated apical defect using synthetic materials

“…Rahkola-Soisalo et al [38] have also studied the role of the influence of the isolated apical defect surgery on the quality of life of the patients. 207 patients were qualified for their study, and they had an isolated apical defect procedure performed using the Vaginal Uphold™ system.…”