title: Midterm prospective comparison of vaginal repair with mesh vs Prolift system devices for prolapse.
abstract: OBJECTIVE
  To compare midterm clinical outcome using modified pelvic floor reconstructive surgery with mesh (MPFR) vs Prolift devices for the treatment of pelvic organ prolapse (POP).
  
  
  METHODS
  This prospective observational cohort study involved 223 women with POP stages III-IV who were assigned to either MPFR (n=131) or Prolift device (n=92). Outcomes were analyzed at 6 and 12 months and the last follow-up visit postoperatively. Main outcome measures included pelvic organ prolapse quantification measurement, Short Form-20 Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) questionnaires, perioperative outcomes, complications, and a personal interview about urinary and sexual symptoms. Statistical analysis included comparison of means (Wilcoxon test or Student's t-test) and proportions (Chi-square test). Multivariate analysis was carried out using Cox proportional hazard model.
  
  
  RESULTS
  At follow-up (median, 36 months; range, 17-58 months), anatomic success for MPFR and Prolift was 87.07% and 93.41%, respectively (P=0.1339). Both operations significantly improved quality of life, and PFDI-20 scores were lower in the Prolift group than the MPFR group (P=0.03). Complication rates did not differ significantly between the two groups and the prevalence of urinary symptoms decreased postoperatively in both groups. The cost of operation, however, was RMB ¥11,882.86 yuan for MPFR and ¥23,617.59yuan for Prolift (P=0.00).
  
  
  CONCLUSIONS
  MPFR and Prolift had comparable anatomic outcomes, Prolift had better functional outcomes than MPFR, but MPFR is much cheaper than Prolift. MPFR is an alternative, cheap and effective surgical treatment option to mesh-kits for the management for POP.
authors: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors: Yi-Song
authors: YS
authors: Chen
authors: Qi
authors: Q
authors: Cao
authors: Jing-Xin
authors: JX
authors: Ding
authors: Chang-Dong
authors: CD
authors: Hu
authors: Wei-Wei
authors: WW
authors: Feng
authors: Ke-Qin
authors: KQ
authors: Hua
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D008422:Materials Testing; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000191:economics / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D053831:Surgical Fixation Devices / Q000009:adverse effects / Q000191:economics; D013526:Surgical Mesh / Q000009:adverse effects / Q000191:economics; D011795:Surveys and Questionnaires; D013810:Therapeutic Equivalency; D014621:Vagina / Q000601:surgery*