Original Article

International Urogynecology Journal

, Volume 24, Issue 10, pp 1679-1686

First online:

Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 5-year prospective follow-up study

  • B. JacquetinAffiliated withDepartment of Obstetrics and Gynaecology, Estaing University HospitalDepartment of Obstetrics-Gynaecology-Human Reproduction, Estaing University Hospital Email author 
  • , P. HinoulAffiliated withMedical Affairs, Ethicon
  • , J. GauldAffiliated withClinical Development, Ethicon
  • , B. FattonAffiliated withDepartment of Obstetrics and Gynaecology, Estaing University Hospital
  • , C. RosenthalAffiliated withDepartment of Gynaecology, Saint Germain Private Hospital
  • , H. ClavéAffiliated withDepartment of Gynaecology, Saint George Private Clinic
  • , O. GarbinAffiliated withDepartment of Obstetrics and Gynaecology, SIHCUS-CMCO University Hospital
  • , J. BerrocalAffiliated withDepartment of Gynaecology, L’Europe Private Clinic
  • , R. VilletAffiliated withDepartment of Gynaecology, Diaconesses Hospital
    • , D. Salet-LizéeAffiliated withDepartment of Gynaecology, Diaconesses Hospital
    • , P. DebodinanceAffiliated withDepartment of Obstetrics and Gynaecology, General Hospital Dunkerque
    • , M. CossonAffiliated withDepartment of Obstetrics and Gynaecology, Jeanne de Flandre University Hospital

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Abstract

Introduction and hypothesis

To evaluate clinical effectiveness and complication rates at 5 years following the total Trans Vaginal Mesh (TVM) technique to treat pelvic organ prolapse.

Methods

Prospective, observational, multi-centre study in patients with prolapse of stage II or higher.

Results

Of the 90 women enrolled in the study, 82 (91 %) were available for the 5-year follow-up period. At the 5-year endpoint, success, defined as no surgical prolapse reintervention and leading edge <−1 (International Continence Society [ICS] criteria) or above the level of the hymen, was 79 % and 87 % respectively. A composite criterion of success defined as: leading edge above the hymen (<0) and no bulge symptoms and no reintervention for prolapse was met by 90 %, 88 % and 84 % at the 1-, 3-, and 5-year endpoints respectively. Quality of life improvement was sustained over the 5 years. Over the 5-year follow-up period, a total of only 4 patients (5 %) required re-intervention for prolapse, while a total of 14 patients (16 %) experienced mesh exposure for which 8 resections needed to be performed. Seven exposures were still ongoing at the 5-year endpoint, all asymptomatic. Only 33 out of 61 (54 %) sexually active patients at baseline remained so at 5 years. De novo dyspareunia was reported by 10 %, but no new cases at the 5-year endpoint. One patient reported de novo unprovoked mild pelvic pain at 5 years, 5 reported pains during pelvic examination only.

Conclusions

Five-year results indicated that TVM provided a stable anatomical repair. Improvements in QOL and associated improvements in prolapse-specific symptoms were sustained. Minimal new morbidity emerged between the 1- and 5-year follow-up.

Keywords

Mesh Pelvic organ prolapse Polypropylene Prolift Transvaginal mesh Vaginal surgery