title: Trocarless system for mesh attachment in pelvic organ prolapse repair--1-year evaluation.
abstract: OBJECTIVE
  EndoFast Reliant system is a novel technology for pelvic organ prolapse (POP) repair that attaches mesh directly with metal fasteners.
  
  
  METHODS
  This was a prospective multicenter study in 20 women who underwent vaginal POP repair to evaluate safety and efficacy. The patients were followed for 12 months, using POP-Q measures, questionnaires on symptoms (PFDI), and sexual function (FSFI).
  
  
  RESULTS
  No intraoperative complications occurred. Prolapse has been anatomically resolved (< stage 2) in 85% at 1-year follow-up (17/20 patients). Pelvic Floor Distress Inventory (PFDI) scores showed significant improvement for 1 year in symptoms related to prolapse (4.1-0.7, p < 0.001) and bladder (1.4-0.7, p = 0.06) but not to rectum. Female Sexual Function Index (FSFI) scores did not change significantly. One case of mesh exposure was found (5%) and treated conservatively. No migration of fasteners was observed on X-ray.
  
  
  CONCLUSIONS
  The EndoFast Reliant system was found safe and efficacious. Future studies are needed to evaluate its advantages over techniques using trocars.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan 52621, Israel. malcalay@netvision.net.il
authors.forename: Menachem
authors.initials: M
authors.lastname: Alcalay
authors.forename: Michel
authors.initials: M
authors.lastname: Cosson
authors.forename: Miron
authors.initials: M
authors.lastname: Livneh
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lucot
authors.forename: Peter
authors.initials: P
authors.lastname: Von Theobald
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D012725:Sexual Behavior; D013525:Surgical Instruments / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000453:epidemiology