Objective: The aim of this study was to assess anatomical and functional outcomes 2 years after prolapse repair using vaginal mesh repair system.
Methods: Women enrolled in a 12-month observational study of outcomes after transvaginal mesh-augmented prolapse repair were invited to participate in an extended follow-up. Subjects completed questionnaires assessing pelvic symptoms, quality of life, global satisfaction, and a pelvic examination for anatomical support and mesh complications.
Results: Of 118 eligible women, 85 enrolled, 82 provided subjective data at 24 months, and pelvic examination/Pelvic Organ Prolapse Quantification data are available from 79 women. Total, anterior, and posterior Prolift kits were used in 47 (55%), 25 (29%), and 13 (15%), respectively. At baseline, most of the women had stage III prolapse (75%), with the anterior compartment constituting the leading edge in 71% of subjects. At 24 months, Pelvic Organ Prolapse Quantification measures were significantly improved from baseline in all compartments, with 51 (65%) stage 0/I, 25 (31%) stage II, 3 (4%) and stage III (P < 0.001), as were quality of life scores (P < 0.001), with the exception of sexual function. Symptomatic prolapse was reported by 7 (8.5%) women, of which 4 demonstrated prolapse in the nonoperated compartment. Three subjects (4%) reported persistent pelvic pain. The 2-year mesh exposure incidence was at least 13% (11/85). The proportion reporting dyspareunia was 28.9% (13/45) and was unchanged from baseline. The median global satisfaction was 9.3 (range 2.0–10.0).
Conclusions: Anatomical support, symptom relief, and satisfaction are high 24 months after mesh-augmented vaginal prolapse repair, although mesh exposure and new onset prolapse of the nonoperated compartment are not uncommon.
Outcomes after vaginal prolapse reconstruction with mesh pelvic floor repair system show high level of anatomic support, symptom relief, and satisfaction.
From the *Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, and †Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PN.
Reprints: Marianna Alperin, MD, MS, Division of FPMRS, Department of Reproductive Medicine, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093-0863. E-mail: firstname.lastname@example.org.
The authors have declared they have no conflicts of interest.