Retrospective multicentre study of the new minimally invasive mesh repair devices for pelvic organ prolapse

Abstract

Objectives To assess the complications and short‐term outcomes of prolapse repair mesh devices used in the management of female pelvic organ prolapse (POP). Design Retrospective cohort study. Setting Multicentre study involving a tertiary referral urogynaecology unit and two district general hospitals. Population 329 women who underwent surgical management of prolapse with various prolapse repair mesh devices in the period between January 2005 and December 2006. Methods Women were identified from theatre records. An independent clinician performed a case notes review during the period March to May 2007. Main Outcome Measures Complication rates and the short‐term cure at 3‐month follow‐up (defined as ≤stage I prolapse on the POP‐Q or Baden Walker scoring systems). Results A total of 289 women were included: 219 (76%) used the Gynecare prolapse repair mesh devices, while 70 women (24%) used the American Medical Systems prolapse repair mesh devices. Operative complications included: bladder injury (1.6%), rectal injury (1.1%) and two women with serious vascular injuries. Postoperative complications included: buttock pain (5.2%), vaginal erosion (10%), one woman with bladder erosion and two women (0.7%) with serious infection, leading to necrotising fasciitis in one woman. Short‐term cure rates in different groups varied from 94 to 100%, depending on vaginal compartment and device used. In total 15 women (5%) had persistent prolapse at 3‐month follow up. Conclusion The new prolapse repair mesh devices demonstrate excellent short‐term cure and low morbidity rates. However, some complications are serious and require highly specialised management. Rigorous evaluation by means of independent, controlled studies is urgently required.

Outcome of Repeat Surgery for Genital Prolapse using Prolift-Mesh

“…This probably may well be because of her age that predisposes to significant supporting ligaments weaknesses. Our success rate of 95.4% is comparable to most studies [5][6][7].…”

Perioperative Complications in Vaginal Mesh Procedures Using Trocar in Pelvic Organ Prolapse Repair

“…In addition paying attention to finger feeling, water leakage, and macro hematuria are important in detection. Some investigators have also recommended blue methylene test and cystoscopy [7,19]. Digital rectal examination should be routinely done in posterior mesh repair to check rectal injury and the absence of mesh tension [17].…”

“…Although the use of synthetic material in prolapse surgery seems to be very effective, as supported by high cure rates, short operating and recovery time, and low recurrence rates [2][3][4][5][6][7][8], clinical experience has shown that implantation of meshes may be associated with side effects, such as pain, mesh exposures and infection, vaginal bleeding, vaginal discharge, fistulas, and dyspareunia [9][10][11][12][13][14].…”

Pelvic organ prolapse transvaginal repair by the Prolift system: Evaluation of efficacy and complications after a 4.5 years follow up

“…POP recurrence occurred in the operated compartment in five cases (two recurrences of rectocele after six-arm Prolift and three anterior recurrences after four-arm Prolif) and six failures were as a result of apparition of a stage 2 rectocele after isolated four-arm Prolift anterior repair. Median PDFI-20 at last follow up was 8 (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], consistent with few symptoms in patients treated. No recurrence led to further surgical intervention.…”

“…8 The Prolift system is a commercially available macroporous polypropylene mesh used for POP repair that has been described in several previous reports. 7,[9][10][11][12][13][14] However, these data have limited follow up. The aim of the present study was to evaluate the anatomical and functional outcomes of transvaginal repair of POP using the Prolift system after a minimal follow up of 3 years.…”