International Urogynecology Journal

, Volume 24, Issue 10, pp 1679–1686

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

  • B. Jacquetin
  • P. Hinoul
  • J. Gauld
  • B. Fatton
  • C. Rosenthal
  • H. Clavé
  • O. Garbin
  • J. Berrocal
  • R. Villet
  • D. Salet-Lizée
  • P. Debodinance
  • M. Cosson
Original Article

DOI: 10.1007/s00192-013-2080-4

Cite this article as:
Jacquetin, B., Hinoul, P., Gauld, J. et al. Int Urogynecol J (2013) 24: 1679. doi:10.1007/s00192-013-2080-4

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

MeshPelvic organ prolapsePolypropyleneProliftTransvaginal meshVaginal surgery

Abbreviations

BMI

Body mass index

ICS

International Continence Society

LOCF

Last observation carried forward

POP

Pelvic organ prolapse

POP-Q

Pelvic organ prolapse quantification

PSI

Prolapse-specific inventory

QOL

Quality of life

SD

Standard deviation

SUI

Stress urinary incontinence

TVM

Transvaginal mesh

Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • B. Jacquetin
    • 1
    • 11
  • P. Hinoul
    • 2
  • J. Gauld
    • 3
  • B. Fatton
    • 1
  • C. Rosenthal
    • 4
  • H. Clavé
    • 5
  • O. Garbin
    • 6
  • J. Berrocal
    • 7
  • R. Villet
    • 8
  • D. Salet-Lizée
    • 8
  • P. Debodinance
    • 9
  • M. Cosson
    • 10
  1. 1.Department of Obstetrics and GynaecologyEstaing University HospitalClermont-FerrandFrance
  2. 2.Medical Affairs, EthiconSomervilleUSA
  3. 3.Clinical Development, EthiconLivingstonUK
  4. 4.Department of GynaecologySaint Germain Private HospitalBrive La GaillardeFrance
  5. 5.Department of GynaecologySaint George Private ClinicNiceFrance
  6. 6.Department of Obstetrics and GynaecologySIHCUS-CMCO University HospitalStrasbourgFrance
  7. 7.Department of GynaecologyL’Europe Private ClinicRouenFrance
  8. 8.Department of GynaecologyDiaconesses HospitalParisFrance
  9. 9.Department of Obstetrics and GynaecologyGeneral Hospital DunkerqueDunkirkFrance
  10. 10.Department of Obstetrics and GynaecologyJeanne de Flandre University HospitalLilleFrance
  11. 11.Department of Obstetrics-Gynaecology-Human ReproductionEstaing University HospitalClermont Ferrand Cedex 1France