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Prospective study of anterior transobturator mesh kit (Prolift™) for the management of recurrent anterior vaginal wall prolapse

International Urogynecology Journal volume 22, pages 157–163 (2011)Cite this article

Abstract

Introduction and hypothesis

Assessment of the 2-year outcome of anterior Prolift™ for women with recurrent anterior vaginal wall prolapse. This is a prospective study which was conducted in a tertiary unit in the North West of England and comprised 36 consecutive women with recurrent anterior vaginal wall prolapse.

Methods

Women were assessed preoperatively and postoperatively at 6 months and 2 years. Women completed the Prolapse Quality of Life Questionnaire (P-QOL), Prolapse and Incontinence Sexual Function Questionnaire-Short Form (PISQ-12), and postoperatively, the Global Impression of Improvement Questionnaire. Women were examined using the Pelvic Organ Prolapse Quantification System (POP-Q). Anatomical success was defined as stage ≤1 prolapse in the anterior compartment. Main outcome measures Postoperative POP-Q stage, quality of life domains and mesh exposure rate.

Results

Preoperatively all but two women had stage 2 or greater anterior vaginal wall prolapse. At a mean follow-up of 24.6 months, 19 women (53%) had stage ≤1 anterior wall prolapse. Fifteen women had stage 2 anterior wall prolapse and two women had stage 3 prolapse. Twenty-nine women felt improvement in their prolapse symptoms. 16 women were sexually active preoperatively, of whom seven reported worsening dyspareunia. There was poor correlation between anatomical and functional outcomes. Seven women had mesh exposure. Five needed revision in theatre.

Conclusions

Anterior Prolift™ for recurrent anterior vaginal wall prolapse has 53% anatomical success rate in the medium term, with mesh exposure rate of 19%. Majority of patients felt overall improvement in their symptoms, but this did not correlate with the anatomical outcome.

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Acknowledgement

This work was supported by the NIHR Manchester Biomedical Research Centre.

Conflicts of interests

A Fayyad received travel sponsorship from Pfizer, Astellas and Ethicon Gynecare and speaker honorarium from Pfizer and Astellas. C North, none. F Reid, received travel sponsorship from Pfizer and speaker honorarium from Pfizer and Boston Scientific. ARB Smith, received lectures and consultation agreements with Johnson and Johnson and Astellas.

Details of ethical approval

This study was approved by the Clinical Governance Committee of Central Manchester University Hospitals Foundation Trust. As this study is part of service evaluation after introduction of Prolift™ into clinical practice, ethical approval was not needed to report the data in this manuscript.

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Affiliations

  1. Warrell Unit, St. Mary’s Hospital, Hathersage Road, Manchester, M13 0JH, UK

    Abdalla M. Fayyad, Carolyn North, Fiona M. Reid & Anthony R.B. Smith

Authors
  1. Abdalla M. Fayyad
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  2. Carolyn North
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  3. Fiona M. Reid
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  4. Anthony R.B. Smith
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Correspondence to Abdalla M. Fayyad.

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Fayyad, A.M., North, C., Reid, F.M. et al. Prospective study of anterior transobturator mesh kit (Prolift™) for the management of recurrent anterior vaginal wall prolapse. Int Urogynecol J 22, 157–163 (2011). https://doi.org/10.1007/s00192-010-1260-8

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  • DOI: https://doi.org/10.1007/s00192-010-1260-8

Keywords

  • Prolapse
  • Anterior wall
  • Mesh
  • Prolift™
  • Recurrent
  • Erosion