Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift™ technique)—a case series multicentric study

Abstract

Our goal was to report the preliminary results of a transvaginal mesh repair of genital prolapse using the Prolift system. This retrospective multicentric study includes 110 patients. All patients had a stage 3 (at the hymen) or stage 4 (beyond the hymen) prolapse. Total mesh was used in 59 patients (53.6%), an isolated anterior mesh in 22 patients (20%) and an isolated posterior mesh in 29 patients (26.4%). We report one bladder injury sutured at surgery and two haematomas requiring secondary surgical management. At 3 months, 106 patients were available for follow-up. Mesh exposure occurred in five patients (4.7%), two of them requiring a surgical management. Granuloma without exposure occurred in three patients (2.8%). Failure rate (recurrent prolapse even asymptomatic or low grade symptomatic prolapse) was 4.7%. According to the perioperative and immediate post-operative results, Prolift repair seems to be a safe technique to correct pelvic organ prolapse. Anatomical and functional results must be assessed with a long-term follow-up to confirm the effectiveness and safety of the procedure.

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.…”

“…7 Briefly, the anterior part of the mesh is positioned between the bladder and vagina with two pairs of arms passing through the obturator foramen. The posterior part is positioned between the rectum and vagina, and fixed by arms passing through the ischiorectal fossa and sacrospinous ligaments on each side.…”

“…4,5 Laparoscopic sacrocolpopexy is a first-line surgical option for anterior and/or posterior POP according to currently available scientific evidence; however, in high-grade POP according to the POP-Q scale, 6 patients presenting risk factors for complications after abdominal surgery (obese, frail, aged or previous abdominal surgery), or in the case of recurrence after surgical management, transvaginal approach has shown positive results. 7 In the case of transvaginal POP repair, the use of a synthetic graft has been described as superior to plicature techniques and the use of biological material. Multiple procedures, using various kits, have been described for anterior and posterior prolapse repair, but often with limited follow up.…”

“…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.…”

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

“…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].…”