title: Transvaginal mesh repair of pelvic organ prolapse by the transobturator-infracoccygeal hammock technique: long-term anatomical and functional outcomes.
abstract: OBJECTIVE
  To evaluate long-term anatomical and functional outcomes of the transobturator-infracoccygeal hammock repair for complex genital prolapse with a porcine collagen-coated polypropylene mesh.
  
  
  METHODS
  A prospective observational study comparing pre- and postoperative outcomes, using pelvic organ prolapse quantification (POP-Q) measurements, pelvic floor distress inventory (PFDI), and pelvic floor impact questionnaire (PFIQ) scores.
  
  
  RESULTS
  One hundred fourteen women with recurrent, advanced, or posthysterectomy genital prolapse were enrolled. During follow-up (median value 57 months), 101 patients were available for assessment. Overall anatomical success rate was 96%, with significant improvement in quality-of-life. Three patients experienced symptomatic recurrent posterior prolapse. Seven had persistent stress urinary incontinence. Mesh exposure occurred in 6.9% of cases, including an infected hematoma that required partial excision of the mesh. No severe adverse event or change in sexual function was observed.
  
  
  CONCLUSIONS
  The transobturator-infracoccygeal hammock is well tolerated with effective long-term anatomical and functional results for complex genital prolapse. In our experience and compared to the data of the literature, the use of collagen-coated versus uncoated polypropylene meshes seems to decrease local morbidity.
authors.affiliation: Department of Obstetrics and Gynecology, Grenoble University Hospital and University of Grenoble, Grenoble Cedex, France. FSergent@chu-grenoble.fr
authors.forename: Fabrice
authors.initials: F
authors.lastname: Sergent
authors.forename: Benoît
authors.initials: B
authors.lastname: Resch
authors.forename: Maysoon
authors.initials: M
authors.lastname: Al-Khattabi
authors.forename: Aude
authors.initials: A
authors.lastname: Ricbourg
authors.forename: Jean-Patrick
authors.initials: JP
authors.lastname: Schaal
authors.forename: Loïc
authors.initials: L
authors.lastname: Marpeau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D016009:Chi-Square Distribution; D020099:Coated Materials, Biocompatible; D003094:Collagen; D004867:Equipment Design; D005260:Female; D005602:France; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology; D056887:Pelvic Organ Prolapse / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011126:Polypropylenes; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*
chemical_list: D020099:Coated Materials, Biocompatible; D011126:Polypropylenes; D003094:Collagen