Vaginal prolapse surgery with transvaginal mesh: results of the Austrian registry
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Introduction and hypothesis
Several mesh repair systems for pelvic organ prolapse (POP) were introduced into clinical practice with limited data on safety, complications or success rates, and impact on sexual function. The Austrian Urogynecology Working Group initiated a registry to assess the use of transvaginal mesh devices for POP repair. We looked at perioperative data, as well as outcomes at 3 and 12 months.
Between 2006 and 2010 a total of 20 gynecology departments in Austria participated in the Transvaginal Mesh Registry. Case report forms were completed to gather data on operations, the postoperative course, and results at 3 and 12 months.
A total of 726 transvaginal procedures with 10 different transvaginal kits were registered. Intra- and perioperative complications were reported in 6.8 %. The most common complication was increased intraoperative bleeding (2.2 %). Bladder and bowel perforation occurred in 6 (0.8 %) and 2 (0.3 %) cases. Mesh exposure was seen in 11 % at 3 and in 12 % at 12 months. 24 (10 %) previously asymptomatic patients developed bowel symptoms by 1 year. De novo bladder symptoms were reported in 39 (10 %) at 3 and in 26 (11 %) at 12 months. Dyspareunia was reported by 7 % and 10 % of 265 and 181 sexually active patients at 3 and 12 months postoperatively respectively.
The 6.8 % rate of intra- and perioperative complications is in line with previous reports. Visceral injury was rare. The 12 % rate of mesh exposure is consistent with previous series.
KeywordsPelvic organ prolapse Vaginal mesh kits Mesh registry
Participating investigators and centers: J. Angleitner, W. Stummvoll (deceased), Krankenhaus der Barmherzigen Schwestern Linz; B. Abendteuer, K. Weghaupt, Landesklinikum Mostviertel Amstetten; M. Börecz, P. Klug, Landeskrankenhaus Judenburg; H. Stöger, D. Wagner, Allgemeinses Krankenhaus Linz; W. Neunteufel, E. Reinstadler, Krankenhaus Dornbirn; H.M.H. Hofmann, M. Konrad, Landeskrankenhaus Feldbach; G. Hartmann, E. Kosteritz, Landeskrankenhaus Gmunden; G. Ralph, G. Müller, Landeskrankenhaus Leoben; O. Preyer, Krankenhaus Göttliches Heiland Wien; A. Dungl, P. Riss, Landesklinikum Mödling; G. Wagner, Krankenhaus der Barmherzigen Brüder, Vienna; Stephan Kropshofer, Medical University of Innsbruck; M. Medl, Hanusch Krankenhaus; B. Dallinger, W. Dirschmayer, B. Schaffer, Krankenhaus der Barmherzigen Schwestern Ried; A. Tammaa, H. Salzer, A. Mirna, P. Lozano, Wilhelminenspital Vienna, P. Roth, Krankenhaus der Barmherzigen Brüder St.Veit/Glan; K. Anzböck, LK Weinviertel Hollabrunn; Dz. Siljak, Landeskrankenhaus Salzburg.
We thank Fedor Daghofer, PhD, for the statistical analysis.
Conflicts of interest
Thomas Aigmueller: paid travel expenses (Ethicon, Gynecare)
Funding of the study
Database and statistical analysis were supported by the Austrian Urogyneology Working Group.
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