International Urogynecology Journal

, Volume 25, Issue 8, pp 1047–1052 | Cite as

Vaginal prolapse surgery with transvaginal mesh: results of the Austrian registry

  • V. Bjelic-Radisic
  • T. Aigmueller
  • O. Preyer
  • G. Ralph
  • I. Geiss
  • G. Müller
  • P. Riss
  • P. Klug
  • M. Konrad
  • G. Wagner
  • M. Medl
  • W. Umek
  • P. Lozano
  • K. Tamussino
  • A. Tammaa
  • for the Austrian Urogynecology Working Group
Original Article

Abstract

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Pelvic organ prolapse Vaginal mesh kits Mesh registry 

Notes

Acknowledgements

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.

References

  1. 1.
    Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Gllazener CM (2010) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 14(4):CD004014. doi: 10.1002/1465185 Google Scholar
  2. 2.
    Olsen AL, Smith VJ, Bergstrom JO, Collong JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRefGoogle Scholar
  3. 3.
    Sokol AI, Iglesia CB, Kudish BI, Gutman RE, Shveiky D, Bercik R, Sokol ER (2012) One-year objective and functional outcomes of a randomized clinical trial of vaginal mesh for prolapse. Am J Obstet Gynecol 2061(86):ee1–ee9Google Scholar
  4. 4.
    Sung VW, Rogers RG, Schaffer JI, Balk EM, Uhling K, Lau J, Abed H, for the Society of Gynecologic Surgeons Systematic Review Group et al (2013) Graft use in transvaginal pelvic organ prolapse repair- a systematic review. Obstet Gynecol 112:1131–1141CrossRefGoogle Scholar
  5. 5.
    Carey M, Slack M, Higgs P, Wynn-Williams M, Cornish A (2007) Vaginal surgery for pelvic organ prolapse using mesh and vaginal support device. BJOG 115:391–397. doi:  10.1111/j.1471-0528.2007.01606.x CrossRefGoogle Scholar
  6. 6.
    McLennan GP, Sirls LT, Killinger KA, Nikolavsky D, Boura JA, Fischer MC, Peters KM (2012) Perioperative experience of pelvic organ prolapse repair with the Prolift and Elevate vaginal mesh procedure. Int Urogynecol J 24:287–294. doi: 10.1007/s00192-012-1830-z PubMedCrossRefGoogle Scholar
  7. 7.
    Abdel-Fattah M, Ramsay I, on behalf of the West of Scotland Study Group (2008) Retrospective multicenter study of the new minimally invasive mesh repair devices for pelvuic organ prolapse. BJOG 115(1):22–30PubMedCrossRefGoogle Scholar
  8. 8.
    Altman D, Falconer CH, for the Nordic transvaginal mesh group (2007) Perioperative morbidity using transvaginal mesh in pelvic organ prolapse repair. Obstet Gynecol 107(1):303–308CrossRefGoogle Scholar
  9. 9.
    Carey M, Higgs P, Goh J, Leong A, Krause H, Cornish A (2009) Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial. BJOG 116:1380–1386. doi: 10.1111/j.1471-0528.2009.02254.x PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Halaska M, Maxova K, Sottner O, Svabik K, Mlcoch M, Kolarik D, Mala I, Krofta L, Halaska J (2012) A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse. Am J Obstet Gynecol 207(4):301, e1–7PubMedGoogle Scholar
  11. 11.
    Menefee SA, Dyer KY, Lukacz ES, Simsiman AJ, Luber KM, Nguyen JN (2011) Colporrhaphy compared with mesh or graft-reinforced vaginal parvaginal repair for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol 118(6):1337–1344PubMedCrossRefGoogle Scholar
  12. 12.
    Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C, Nordic Transvaginal Mesh Group (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364(19):1826–1836PubMedCrossRefGoogle Scholar
  13. 13.
    Sentilhes L, Bwerthier A, Sergent F, Verspyck E, Descamps P, Marpeau L (2008) Sexual function in women before and after transvaginal mesh placement for pelvic organ prolapse. Int Urogynecol J 19:763–772CrossRefGoogle Scholar
  14. 14.
    Fatton B, Amblard J, Debodinanace P, Cosson M, Jacqutin B (2007) Transvaginal repair of genital prolapse: preliminary results of new tension-free vaginal mesh (Prolift technique)- a case series multicentric study. Int Urogynecol J Pelvic Floor Dysfunct 18:743–752PubMedCrossRefGoogle Scholar
  15. 15.
    Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, Heinonen PK (2010) Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 years follow up. Am J Obstet Gynecol 203:235, e1–235.e8PubMedCrossRefGoogle Scholar
  16. 16.
    Guldberg R, Brostrom S, Hansen JK, Kaerlev L, Gradel KO, Norgard BL, Kesmodel US (2013) The Danish Urogynecological Database: establishment, completeness and validity. Int Urogynecol J Pelvic Floor Dysfunct 24:983–990CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2014

Authors and Affiliations

  • V. Bjelic-Radisic
    • 1
  • T. Aigmueller
    • 1
  • O. Preyer
    • 2
  • G. Ralph
    • 3
  • I. Geiss
    • 4
  • G. Müller
    • 3
  • P. Riss
    • 4
  • P. Klug
    • 5
  • M. Konrad
    • 6
  • G. Wagner
    • 7
  • M. Medl
    • 8
  • W. Umek
    • 9
  • P. Lozano
    • 10
  • K. Tamussino
    • 1
  • A. Tammaa
    • 10
  • for the Austrian Urogynecology Working Group
  1. 1.Department of Obstetrics and GynecologyMedical University of GrazGrazAustria
  2. 2.Department of Obstetrics and GynecologyBezirkskrankenhaus Zell am SeeZell am SeeAustria
  3. 3.Department of Obstetrics and GynecologyLandeskrankenhaus LeobenLeobenAustria
  4. 4.Department of Obstetrics and GynecologyLandesklinikum MödlingMödlingAustria
  5. 5.Department of Obstetrics and GynecologyLandeskrankenhaus RottenmannSt. GeorgenAustria
  6. 6.Department of Obstetrics and GynecologyLandeskrankenhaus FeldbachFeldbachAustria
  7. 7.Department of Obstetrics and GynecologyKrankenhaus der Barmherzigen BruderViennaAustria
  8. 8.Department of Obstetrics and GynecologyHanusch-KrankenhausViennaAustria
  9. 9.Department of Obstetrics and GynecologyMedical University of ViennaViennaAustria
  10. 10.Department of Obstetrics and GynecologyWilhelminenspitalViennaAustria

Personalised recommendations