Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device.

Abstract

INTRODUCTION AND HYPOTHESIS:

This study was designed to evaluate clinical outcomes ≥2 years following surgery with polypropylene mesh and vaginal support device (VSD) in women with vaginal prolapse, in a prospective, multi-center setting.

METHODS:

Patients re-consented for this extended follow-up (n = 110), with anatomic evaluation using Pelvic Organ Prolapse Quantification (POP-Q) and validated questionnaires to assess pelvic symptoms and sexual function. Complications were recorded (safety set; n = 121).

RESULTS:

Median length of follow-up was 29 months (range 24-34 months). The primary anatomic success, defined as POP-Q 0-I, was 69.1%; however, in 84.5% of the cases, the leading vaginal edge was above the hymen. Pelvic symptoms and sexual function improved significantly from baseline (p < 0.01). Mesh exposure rate was 9.1%. Five percent reported stress urinary incontinence and 3.3% required further prolapse surgery.

CONCLUSION:

These results indicate this non-anchored mesh repair is a safe and effective treatment for women with symptomatic vaginal prolapse in the medium term.

• Authors: T Sayer, J Lim, J M Gauld, P Hinoul, P Jones, N Franco, D Van Drie, M Slack, Prosima Study Investigators
• Journal: International urogynecology journal (Int Urogynecol J) Vol. 23 Issue 4 Pg. 487-93 (Apr 2012) ISSN: 1433-3023 [Electronic] England
• PMID: 22143448 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Polypropylenes

Topics

• Aged
• Cohort Studies
• Female
• Follow-Up Studies
• Gynecologic Surgical Procedures (instrumentation, methods)
• Humans
• Middle Aged
• Polypropylenes
• Suburethral Slings (adverse effects)
• Surgical Mesh (adverse effects)
• Surveys and Questionnaires
• Treatment Outcome
• Uterine Prolapse (surgery)