Transvaginal mesh (Prolift™) repair: 2-year anatomic outcomes

Nair, Roopa; Nnochiri, Akobundu; Barnick, Christian; Roberts, Catharine

doi:10.1016/j.ejogrb.2011.06.019

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…[9] These rates are compatible with the lower end of existing data, from 1–24%; most falling under 15%. [9,14,20,22–29] As expected, all exposures in this study were seen in patients with significant vaginal atrophy noted on examination. All had discontinued vaginal estrogen use after surgery.…”

Section: Discussionsupporting

confidence: 78%

Synthetic Graft Augmentation in Vaginal Prolapse Surgery: Long-Term Objective and Subjective Outcomes

Meyer

McGwin

Swain

et al. 2016

Journal of Minimally Invasive Gynecology

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Objective To report long-term objective and subjective outcomes of women who have undergone prolapse surgery with a synthetic graft augmentation. Design Retrospective analysis Design Class Canadian Task Force classification II-3 Setting An university hospital in southeastern United States. Patients Women with symptomatic pelvic organ prolapse who underwent transvaginal graft augmentation using the Prolift™ system between July 2006 and December 2008 for a minimum of 5 year follow-up. Interventions Subjects completed the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ), and the Patient Satisfaction Questionnaire. Subjects also underwent post-operative physical examination with Pelvic Organ Prolapse Quantification (POP-Q) and vaginal pain/stricture assessment. Long-term postoperative findings were compared to preoperative baseline data. Measurements and main results Of 208 eligible subjects; 70 completed questionnaires only, and 48/70 provided both postoperative examination and questionnaire data. Mean follow-up interval was 7.0±0.7 (range: 5.8–8.1) years. POP-Q measurements of Ba, Bp, C, GH, PB and overall POP stage significantly improved (all p<.001 except for PB, p=.006). PFIQ (total, UIQ, POPIQ) and PFDI (total, UDI, POPDI) scores significantly improved (all p<.001). No differences were noted in the Colorectal-Anal subscales (CRAIQ, CRADI) and PISQ scores at >5 year follow-up (all p>.05). Satisfaction rates were 15.7% not at all, 35.7% somewhat, and 48.6% completely satisfied. Complications [n(%)] included graft exposure [3(6%)] and dyspareunia [25(36%)]. Conclusion Women undergoing transvaginal prolapse surgery using a synthetic graft continue to have positive objective and subjective outcomes leading to significantly improved quality of life at a minimum of 5 year follow-up.

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Section: Discussionsupporting

confidence: 78%

Synthetic Graft Augmentation in Vaginal Prolapse Surgery: Long-Term Objective and Subjective Outcomes

Meyer

McGwin

Swain

et al. 2016

Journal of Minimally Invasive Gynecology

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“…Indeed , we present a mean follow up over 4 years when other studies have a maximum follow up of approximately 2 years, 13,14,[16][17][18][19][20][21] except a recent report dealing with re-operation rate (Table 5). 14 Our initiative is further legitimized by previous expert opinions underlining that 2 years should be considered as the minimal postoperative follow up for evaluating the outcome of pelvic floor reconstructive surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Our 5.3% rate of mesh exposure is one of the less important of those recently reported (Table 5). 13,14,[16][17][18][19][20][21]23 In a meta-analysis, Feiner described an exposure rate ranging from 4.6% to 10.7% for transvaginal mesh kits. 28 The previously assessed link between learning Long-term results with Prolift curve and incidence of mesh exposure 29 could explain the low incidence of erosion in the present study, where all interventions were carried out or supervised by two very experienced surgeons (FH and VD).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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Objectives: The Prolift system is a polypropylene device designed for pelvic organ prolapse repair by a transvaginal approach. Numerous studies have reported on shortterm outcomes of this procedure, but long-term studies are lacking. Methods: A retrospective study of patients who underwent pelvic organ prolapse repair by Prolift between September 2005 and September 2008 was carried out in two tertiary reference centers by two experienced surgeons. Preoperative and postoperative follow up was based on medical records of baseline and follow-up visits with complete clinical examination, including Pelvic Organ Prolapse Quantification stage. At last follow up, the Pelvic Floor Distress Inventory-20 questionnaire was assessed by telephone interview. Cure was defined as an anatomical success at last follow up, being a Pelvic Organ Prolapse Quantification stage Յ1 without further surgical intervention in any compartment. Results: A total of 75 patients were included in this analysis with a mean follow up of 53.7 Ϯ 8.8 months (range 36-72 months). Patients were treated with two-arm Prolift posterior, four-arm Prolift anterior and six-arm Prolift total in three (4%), 51 (69%) and 21 (27%) cases, respectively. At last follow up, 64 (85.3%) patients were cured , with no prolapse recurrence. Mesh exposure occurred in four (5.3%) patients. The Pelvic Floor Distress Inventory-20 symptom score was low at last follow up (median 8, range 3-18), in accordance with objective cure data. Conclusions: The Prolift system is safe and efficacious for pelvic organ prolapse repair by transvaginal approach after a 4.5-year follow up.

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“…Sanses and colleagues in comparing short-term outcomes of vaginal mesh repair to abdominal sacral colpopexy for management of apical prolapse reported an anatomic cure rate of 98.8% for vaginal mesh repair and 99.3% with abdominal sacral colpopexy at three to six months follow-up [3]. A retrospective study of 56 patients who underwent Prolift ® vaginal mesh procedures reported a cure rate of 91% at 21 months follow-up [11], and another series of 60 patients with median follow-up of 29 months reported success rate of 85% with 15% rate of mesh exposure [6]. Others have reported rates of mesh exposure between 1% and 25% [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Awareness of mesh-related complications has recently increased, causing some regulatory agencies to issue advisory statements regarding use of TVM [4]. There have been several studies reporting short and medium term outcomes after TVM [3,5,6]. However, there is limited data on the predictors of outcome after TVM.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Outcome after Transvaginal Mesh for Pelvic Organ Prolapse

Anusionwu¹,

Loeb²,

Juraschek³

et al. 2012

OJU

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Introduction: We aim to report outcomes and predictors of outcome of transvaginal mesh (TVM) for pelvic organ prolapse (POP). We also report frequency, severity, risk factors, and management of mesh-related complications after TVM. Materials and methods: We performed retrospective chart review of TVM performed from 2005 to 2010. There were 67 patients followed for a mean duration of eighteen months. Complications were reported using the International Continence Society and International Urogynecological Association classification system for prosthesis/graft complication. Results: Success rate was 88% (97% for anterior repair, 100% for posterior repair and 71% for combined repair) and complications occurred in 13 patients (19%), including vaginal hematoma, pelvic pain, urinary retention, dyspareunia and vaginal mesh exposure (in 9 patients). On multivariable logistic regression, recurrence was significantly higher with combined repair (P = 0.021), overall complication was significantly associated with younger age (P = 0.019), and mesh exposure was significantly associated with age and combined repair. All mesh-related complications were vaginal exposures occurring at median of 6 months postoperatively. Two patients were managed conservatively with vaginal estrogen cream, while seven patients elected surgical excision of exposed mesh with primary re-approximation of the vaginal epithelium. There were no excision-related complications, and in no case was the defect large enough to require closure with graft or secondary material. Conclusion: Combined anterior and posterior repair using TVM is associated with failure, younger age is associated with higher rate of complication, and combined repair and younger age are associated with mesh-related complication specifically

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Transvaginal mesh (Prolift™) repair: 2-year anatomic outcomes

Cited by 10 publications

References 14 publications

Synthetic Graft Augmentation in Vaginal Prolapse Surgery: Long-Term Objective and Subjective Outcomes

Synthetic Graft Augmentation in Vaginal Prolapse Surgery: Long-Term Objective and Subjective Outcomes

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

Predictors of Outcome after Transvaginal Mesh for Pelvic Organ Prolapse

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