Skip to main content

Advertisement

SpringerLink
Log in

Single-incision mesh repair versus traditional native tissue repair for pelvic organ prolapse: results of a cohort study

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

To compare the efficacy and safety of the Elevate™ anterior and posterior prolapse repair system and traditional vaginal native tissue repair in the treatment of stage 2 or higher pelvic organ prolapse.

Methods

A cohort study was conducted between January 2010 and July 2012. Patients who underwent transvaginal pelvic reconstruction surgery for prolapse were recruited. The primary outcome was anatomical success 1 year after surgery. The secondary outcome included changes in the quality of life and surgical complications. Recurrence of prolapse was defined as stage 2 or higher prolapse based upon the pelvic organ prolapse qQuantification system.

Results

Two hundred and one patients (100 in the Elevate™ repair group and 101 in the traditional repair group) were recruited and analyzed. The anatomical success rate of the anterior compartment was significantly higher in the Elevate™ repair group than in the traditional repair group (98 % vs 87 %, p = 0.006), but not for the apical (99 % vs. 6 %, p = 0.317) or posterior (100 % vs 97 %, p = 0.367) compartments after a median 12 months of follow-up. Both groups showed significant improvements in the quality of life after surgery with no statistical difference. Mesh-related complications included extrusion (3 %) and the need for revision of the vaginal wound (1 %). Those in the mesh repair group had a longer hospital stay (p = 0.04), operative time (p < 0.001), and greater estimated blood loss (p = 0.05). Other complications were comparable with no statistical difference.

Conclusions

The Elevate™ prolapse repair system had a better 1-year anatomical cure rate of the anterior compartment than traditional repair, with slightly increased morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

POP:

Pelvic organ prolapse

UDI-6:

Urogenital Distress Inventory (short form)

IIQ-7:

Incontinence Impact Questionnaire (short form)

PISQ-12:

Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (short form)

References

  1. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  CAS  PubMed  Google Scholar 

  2. Kenton K, Mueller ER (2006) The global burden of female pelvic floor disorders. BJU Int 98 [Suppl 1]:1–5

    Article  PubMed  Google Scholar 

  3. Maher C, Baessler K (2006) Surgical management of anterior vaginal wall prolapse: an evidence based literature review. Int Urogynecol J Pelvic Floor Dysfunct 17:195–201

    Article  PubMed  Google Scholar 

  4. Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM (2010) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 14:CD004014

    Google Scholar 

  5. Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. BJOG 111:831–836

    Article  PubMed  Google Scholar 

  6. 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 364:1826–1836

    Article  Google Scholar 

  7. Su TH, Liu PE, Lau HH, Huang WC, Lin TY, Hsieh CH (2011) Impact of Prolift procedure on bladder function and symptoms in women with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 22:585–590

    Article  Google Scholar 

  8. FDA (2011) FDA Safety Communications: UPDATE on serious complications associated with transvaginal placement of surgical mesh for pelvic organ prolapse. http://www.fda.gov/MedicalDevices/ Safety/AlertandNotices/ucm262435.htm. Accessed 13 July 2011

  9. Haylen BT, Sand PK, Swift SE, Maher C, Moran PA, Freeman RM (2012) Transvaginal placement of surgical mesh for pelvic organ prolapse: more FDA concerns—positive reactions are possible. Int Urogynecol J 23:11–13

    Article  PubMed  Google Scholar 

  10. Murphy M, Holzberg A, van Raalte H, Kohli N, Goldman HB, Lucente V, Network PS (2012) Time to rethink: an evidence-based response from pelvic surgeons to the FDA Safety Communication: “UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse”. Int Urogynecol J 23:5–9

    Article  PubMed  Google Scholar 

  11. Moore RD, Mitchell GK, Miklos JR (2012) Single-incision vaginal approach to treat cystocele and vault prolapse with an anterior wall mesh anchored apically to the sacrospinous ligaments. Int Urogynecol J 23:85–91

    Article  PubMed Central  PubMed  Google Scholar 

  12. Lukban JC, Roovers JP, Vandrie DM et al (2012) Single-incision apical and posterior mesh repair: 1-year prospective outcomes. Int Urogynecol J 23:1413–1419

    Article  PubMed  Google Scholar 

  13. Stanford EJ, Moore RD, Roovers JP et al (2013) Elevate anterior/apical: 12-month data showing safety and efficacy in surgical treatment of pelvic organ prolapse. Female Pelvic Med Reconstr Surg 19:79–83

    Article  PubMed  Google Scholar 

  14. Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  CAS  PubMed  Google Scholar 

  15. Uebersax JS, Wyman JF, Shumaker SA et al (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: The incontinence impact questionnaire and the urogenital distress inventory. Continence program for women research group. Neurourol Urodyn 14:131–139

    Article  CAS  PubMed  Google Scholar 

  16. Su TH, Lau HH (2010) Validation of a Chinese version of the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire. J Sex Med 7:3940–3945

    Article  PubMed  Google Scholar 

  17. Su TH, Lau HH, Huang WC et al (2009) Short term impact on female sexual function of pelvic floor reconstruction with the Prolift procedure. J Sex Med 6:3201–3207

    Article  PubMed  Google Scholar 

  18. Dietz V, Huisman M, Joyce M et al (2008) Functional outcome after sacrospinous hysteropexy for uterine descensus. Int Urogynecol J Pelvic Floor Dysfunct 19:747–752

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author contributions

TH Su—protocol/project development and manuscript writing/editing; HH Lau—data collection or management, manuscript writing/editing and data analysis; WC Huang—data collection or management; CH Hsieh—data analysis; RC Chang—data collection and management; CH Su—data analysis.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan

    Tsung-Hsien Su, Hui-Hsuan Lau & Wen-Chu Huang

  2. Mackay Medicine, Nursing and Management College, Taipei, Taiwan

    Tsung-Hsien Su, Hui-Hsuan Lau, Wen-Chu Huang, Rhu-Chu Chang & Chin-Hui Su

  3. Taipei Medical University, Taipei, Taiwan

    Tsung-Hsien Su, Hui-Hsuan Lau, Wen-Chu Huang & Chin-Hui Su

  4. Mackay Medical College, Taipei, Taiwan

    Tsung-Hsien Su & Hui-Hsuan Lau

  5. Department of Obstetrics and Gynecology, Clinic of Fu Jen Catholic University, Taipei, Taiwan

    Ching-Hung Hsieh

  6. Department of Otorhinolaryngology, Mackay Memorial Hospital, Taipei, Taiwan

    Chin-Hui Su

  7. #92 Sec. 2 Chung-Shan North Road, Taipei, 104, Taiwan

    Tsung-Hsien Su

Authors
  1. Tsung-Hsien Su
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui-Hsuan Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wen-Chu Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ching-Hung Hsieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rhu-Chu Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chin-Hui Su
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tsung-Hsien Su.

Additional information

T.-H. Su and H.-H. Lau contributed equally to this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Su, TH., Lau, HH., Huang, WC. et al. Single-incision mesh repair versus traditional native tissue repair for pelvic organ prolapse: results of a cohort study. Int Urogynecol J 25, 901–908 (2014). https://doi.org/10.1007/s00192-013-2294-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-013-2294-5

Keywords

Search

Navigation