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Pelvic Organ Prolapse Repair Using the Uphold Vaginal Support System

5-Year Follow-Up

Rahkola-Soisalo, Päivi, MD, PhD*; Mikkola, Tomi S., MD, PhD*†; Altman, Daniel, MD, PhD‡§; Falconer, Christian, MD, PhD§ for the Nordic TVM Group

Female Pelvic Medicine & Reconstructive Surgery: May/June 2019 - Volume 25 - Issue 3 - p 200–205
doi: 10.1097/SPV.0000000000000530
Original Articles
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Objective This study aimed to assess the long-term (5 years) outcomes of the Uphold Vaginal Support System for symptomatic vaginal apical prolapse with or without anterior colporraphy.

Methods In total, 164 (81.2%) of 202 women operated on in 24 centers were reached for follow-up. Outcomes were assessed by using the Pelvic Organ Prolapse Quantification, the Pelvic Floor Distress Inventory 20, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire questionnaires. Pain on pelvic area was evaluated using a visual analog scale. Adverse events and secondary procedures were recorded.

Results An optimal outcome at the apical compartment (Pelvic Organ Prolapse Quantification stage <2) was achieved in 83.3% of patients (94% at 1 year). Quality of life improved in 78.8% of the women, with a significant decrease of bother in all domains (pelvic organ prolapse, rectoanal, urinary) compared with that preoperatively. Overall sexual satisfaction improved after 1 year, but the number of sexually active women was low. In total, 19.7% of patients had undergone repeat pelvic surgery during follow-up, most common of these were midurethral sling (38.4%), followed by prolapse-related operations. Mesh removal due to pain was performed in 3 women. Number of women with any pain decreased overall from 1 to 5 years, but 3 women had persistent severe pain despite treatment efforts (visual analog scale ≥7).

Conclusions Apical objective and subjective outcomes were sustained after 5 years in women operated on for apical compartment prolapse by the Uphold Vaginal Support System.

Apical objective and subjective outcomes were sustained after 5 years in women operated on for apical compartment prolapse by the Uphold Vaginal Support System.

From the *Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital;

Folkhälsan Research Center, Helsinki, Finland;

Stockholm Urogynecological Clinic, Stockholm; and

§Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden.

Correspondence: Päivi Rahkola-Soisalo, MD, PhD, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 2, Box 140, 00029 HUS, Helsinki, Finland. E-mail: paivi.rahkola-soisalo@hus.fi.

Conflict of Interest: P. Rahkola-Soisalo has received funding for congress trips from Johnson & Johnson and Astellas. T.S. Mikkola has received speaking honoraria from Astellas and Contura. D. Altman has received speaking and advisory honoraria from Gedeon Richter, Pfizer, Astellas, Invent Medic, and Gynecare. C. Falconer has received speaking and advisory honoraria from Boston Scientific and Johnson & Johnson.

The study was supported by an investigator-initiated grant from Boston Scientific and the Swedish Scientific Council.

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