Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device
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- Sayer, T., Lim, J., Gauld, J.M. et al. Int Urogynecol J (2012) 23: 487. doi:10.1007/s00192-011-1600-3
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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.
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).
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.
These results indicate this non-anchored mesh repair is a safe and effective treatment for women with symptomatic vaginal prolapse in the medium term.
KeywordsPelvic organ prolapsePolypropylene meshVaginal surgeryVaginal support device
- ICS POP-Q
International Continence Society Pelvic Organ Prolapse Quantification
Patient Global Impression of Change
Pelvic Floor Distress Inventory
Pelvic Floor Impact Questionnaire
Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire
Quality of life
Vaginal support device