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Prospective ultrasonographic follow-up of transvaginal lightweight meshes: a 1-year multicenter study

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Abstract

Introduction and hypothesis

The use of new lightweight meshes in pelvic organ prolapse (POP) surgery may reduce complications related to mesh retraction (chronic pain, dyspareunia, and mesh exposure). The aim of this study was to investigate changes in the area and position of Uphold Lite™ mesh 6 weeks and 12 months after anterior and/or apical prolapse repair.

Methods

This observational prospective multicenter study included patients who had undergone transvaginal surgery for symptomatic POP-Q stage ≥ II anterior and/or apical compartment prolapse with placement of Uphold Lite mesh. The dimensions and position of the mesh were evaluated at 6 weeks and 12 months by ultrasonography. Correlations between ultrasonographic mesh characteristics and POP recurrence were analyzed.

Results

Fifty evaluable women with an average age of 66.8 years were included. No statistically significant difference in mesh area was found between week 6 and month 12 postoperatively, either at rest (1746.92 vs. 1574.48 mm2; p = 0.15) or on Valsalva (1568.81 vs. 1542.98 mm2; p = 0.65). The ROC-AUC of the distance between the mesh and the bladder neck (M-BN) at 6 weeks for predicting cystocele recurrence at 12 months was 0.764 (95% CI 0.573–0.955) at rest and 0.724 (95% CI 0.533–0.916) on Valsalva. An M-BN distance > 12.5 mm could predict cystocele recurrence at month 12 with a sensitivity of 80% and a specificity of 69%.

Conclusions

Ultrasonographic measurements of the Uphold Lite™ mesh appear to remain stable between 6 weeks and 12 months postoperatively. M-BN distance correlates with cystocele recurrence. These results appear to confirm the value of ultrasound in mesh evaluation.

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Acknowledgments

We thank the BESPIM department of Nîmes University Hospital for statistical analysis and data management.

We thank all the investigators, including those not listed as authors: Philippe Debodinance, Christophe Courtieu, Melanie Cayrac, Xavier Fritel, Maxime Marcelli, Aubert Agostini, and François Monneins.

Funding

This study was partially funded by Boston Scientific, but the company had no influence over the execution of the study, data analysis, or interpretation of the data and was not involved in drafting the manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nîmes University Hospital, Nîmes, France

    Lucie Allègre, Geertje Callewaert, Charles Coudray, Vincent Letouzey, Renaud de Tayrac & Brigitte Fatton

  2. Department of BESPIM (Biostatistics, Epidemiology, Public Health, and Innovation in Methodology), Nîmes University Hospital, Nîmes, France

    Christophe Demattei

  3. Department of Gynecology, Clinique Beau Soleil, Montpellier, France

    Laure Panel

  4. Department of Obstetrics and Gynecology, Camille Guérin Hospital, Châtellerault, France

    Caroline Carlier-Guerin

Authors
  1. Lucie Allègre
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  2. Geertje Callewaert
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  3. Charles Coudray
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  4. Christophe Demattei
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  5. Laure Panel
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  6. Caroline Carlier-Guerin
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  7. Vincent Letouzey
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  8. Renaud de Tayrac
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  9. Brigitte Fatton
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Contributions

L Allègre: Data collection, Data analysis, Manuscript writing/editing.

G Callewaert: Dataanalysis, Manuscript writing/editing.

C Coudray: Data analysis, Manuscript writing.

C Demattei: Data analysis.

L Panel: Data collection.

C Carlier-Guerin: Data collection.

V Letouzey: Protocol development.

R de Tayrac: Protocol development, Data collection, Manuscript editing.

B Fatton: Protocol development, Data collection, Manuscript editing.

Corresponding author

Correspondence to Lucie Allègre.

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Conflict of interest

R. de Tayrac and B. Fatton are consultant for Boston Scientific.

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Allègre, L., Callewaert, G., Coudray, C. et al. Prospective ultrasonographic follow-up of transvaginal lightweight meshes: a 1-year multicenter study. Int Urogynecol J 32, 1505–1512 (2021). https://doi.org/10.1007/s00192-020-04483-2

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  • DOI: https://doi.org/10.1007/s00192-020-04483-2

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