Trocar-guided total tension-free vaginal mesh repair of post-hysterectomy vaginal vault prolapse.
OBJECTIVE
The objective of this study was to report 1 year anatomical and functional outcomes of trocar-guided total tension-free vaginal mesh (Prolift) repair for post-hysterectomy vaginal vault prolapse with one continuous piece of polypropylene mesh.


METHODS
We conducted a prospective observational cohort study of 46 patients. A minimum sample size of 35 patients was needed to detect a recurrence rate of less than 20% at 12 months. Instruments of measurement used were pelvic organ prolapse quantification and validated questionnaires.


RESULTS
Overall anatomical success was 91% (95% confidence interval 83-99), with significant improvement in experienced bother and quality of life. Mesh exposure occurred in seven patients (15%). No adverse effects on sexual function could be detected.


CONCLUSIONS
Trocar-guided total tension-free vaginal mesh (Prolift) repair with one continuous piece of mesh for post-hysterectomy vaginal vault prolapse is well tolerated and anatomically and functionally highly effective. Results of controlled trials will determine its position in the operative armamentarium.
Milani
Alfredo L
AL
Department of Obstetrics and Gynaecology, Reinier de Graaf Group, Delft, The Netherlands. almilani@telfort.nl
Withagen
Mariella I J
MI
Vierhout
Mark E
ME
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020884:Colpotomy / Q000009:adverse effects / Q000295:instrumentation; D004414:Dyspareunia / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome