Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device.
OBJECTIVE
To describe a new surgical procedure for pelvic organ prolapse using mesh and a vaginal support device (VSD) and to report the results of surgery.


METHODS
A prospective observational study.


METHODS
Two tertiary referral Urogynaecology practices.


METHODS
Ninety-five women with International Continence Society pelvic organ prolapse quantification stage 2 or more pelvic organ prolapse who underwent vaginal surgery using mesh augmentation and a VSD.


METHODS
Surgery involved a vaginal approach with mesh reinforcement and placement of a VSD for 4 weeks. At 6 and 12 months, women were examined for prolapse recurrence, and visual analogue scales for satisfaction were completed. Women completed quality-of-life (QOL) questionnaires preoperatively and at 6 and 12 months.


METHODS
Objective success of surgery at 6 and 12 months following surgery. Secondary outcomes were subjective success, complications, QOL outcomes and patients' satisfaction.


RESULTS
Objective success rate was 92 and 85% at 6 and 12 months, respectively. Subjective success rate was 91 and 87% at 6 and 12 months, respectively. New prolapse in nonrepaired compartments accounted for 7 of 12 (58%) failures at 12 months. Two of 4 mesh exposures required surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 23% at 12 months. QOL scores significantly improved at 12 months compared with baseline (P < 0.0001).


CONCLUSIONS
Vaginal surgery using mesh and a VSD is an effective procedure for pelvic organ prolapse. However, further studies are required to establish the role of the surgery described in this study.
Carey
M
M
Department of Urogynaecology, Royal Women's Hospital, Melbourne, Victoria, Australia. mcarey@netlink.com.au
Slack
M
M
Higgs
P
P
Wynn-Williams
M
M
Cornish
A
A
D004867:Equipment Design; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods; D007902:Length of Stay; D008875:Middle Aged; D017060:Patient Satisfaction; D010570:Pessaries; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery