title: Prospective study of anterior transobturator mesh kit (Prolift™) for the management of recurrent anterior vaginal wall prolapse.
abstract: OBJECTIVE
  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.
authors.affiliation: Warrell Unit, St. Mary's Hospital, Hathersage Road, Manchester, M13 0JH, UK. amfayyad@hotmail.com
authors.forename: Abdalla M
authors.initials: AM
authors.lastname: Fayyad
authors.forename: Carolyn
authors.initials: C
authors.lastname: North
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Reid
authors.forename: Anthony R B
authors.initials: AR
authors.lastname: Smith
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D053825:Suburethral Slings; D013526:Surgical Mesh