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Transvaginal Mesh Surgery for Pelvic Organ Prolapse: One-Year Outcome Analysis

Khandwala, Salil MD

Female Pelvic Medicine & Reconstructive Surgery:
doi: 10.1097/SPV.0b013e31827de6de
Original Articles
Abstract

Objective: The aim of the study was to assess the role of Prolift + M (PP-PG) vaginal mesh surgery to correct uterovaginal prolapse not only from an anatomic but also a subjective (patient’s) standpoint.

Methods: A prospective cohort of subjects treated with transvaginal mesh for prolapse between April 2009 and November 2010 was analyzed. A composite score that included subjective criteria of absence of a bothersome bulge and objective criteria based on Pelvic Organ Prolapse Quantification lower than stage II was used to assess treatment success.

Results: Transvaginal mesh was performed in 157 subjects (age, 64.7 ± 11.6 years; body mass index, 28.5 ± 4.8 kg/m2) for pelvic organ prolapse. Five anterior mesh surgeries (3.2%), 48 posterior mesh surgeries (30.6%), and 104 total mesh surgeries (66.2%) were performed in subjects with stage II or greater degrees of prolapse. Stage II prolapse was noted in 44 subjects (28.0%), 91 subjects (58.0%) had stage III prolapse, and 22 subjects (14.0%) had stage IV prolapse. The mean follow-up was 13 months. Our composite success score was 88.1%. Pure anatomic success based on Pelvic Organ Prolapse Quantification lower than stage II was 94%. The mean operative time was 117.8 ± 42.4 minutes. The mean intraoperative blood loss was 106.1 ± 116.4 mL. There were 3 cases (2.2%) of mesh exposure in the vagina. There were no visceral injuries. The incidence of de novo dyspareunia was 6%.

Conclusion: Transvaginal PP-PG mesh surgery is safe and effective with few postoperative morbidities.

In Brief

Transvaginal mesh surgery is effective for management of pelvic organ prolapse.

Author Information

From the Oakwood Hospital and Medical Center, Dearborn, MI.

Reprints: Salil Khandwala, MD, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, 18100 Oakwood Blvd, Suite 213, Dearborn, MI 48124. E-mail: admin@augm.org.

Dr. Khandwala is a consultant for Ethicon, Inc. No funding was received for this work.

The author has declared that there are no conflicts of interest.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins