Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 3-year prospective follow-up study.
OBJECTIVE
To evaluate clinical outcomes at 3 years following total transvaginal mesh (TVM) technique to treat vaginal prolapse.


METHODS
Prospective, observational study in patients with prolapse ≥ stage II. Success was defined as POP-Q-stage 0-I and absence of surgical re-intervention for prolapse. Secondary outcome measures were: quality of life (QOL), prolapse-specific inventory (PSI), impact on sexual activity and complications.


RESULTS
Ninety women underwent TVM repair, 72 a hysterectomy. Anatomical failure rate was 20.0% at 3 years. Three patients required re-intervention for prolapse. Improvements in QOL- and PSI-scores were observed at 1 and 3 years. Vaginal mesh extrusion occurred in 14.4% patients. After 3 years, 4.7% asymptomatic extrusions remained present. Of 61 sexually active women at baseline, a significant number of patients (41%) ceased sexual activity by 3 years; de novo dyspareunia was reported by 8.8%. One vesico-vaginal fistula resolved after surgery.


CONCLUSIONS
Medium-term results demonstrate that the TVM technique provides a durable prolapse repair.
Jacquetin
Bernard
B
Department of Obstetrics and Gynaecology, Hôtel-Dieu Maternité, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France. bjacquetin@chu-clermontferrand.fr
Fatton
Brigitte
B
Rosenthal
Claude
C
Clavé
Henri
H
Debodinance
Philippe
P
Hinoul
Piet
P
Gauld
Judi
J
Garbin
Olivier
O
Berrocal
Juan
J
Villet
Richard
R
Salet Lizée
Delphine
D
Cosson
Michel
M
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012725:Sexual Behavior; D013526:Surgical Mesh; D016896:Treatment Outcome