title: Retrospective study of transobturator polypropylene mesh kit for the management of pelvic organ prolapse.
abstract: BACKGROUND
  This retrospective study assessed the surgical outcomes of patients for whom the transobturator polypropylene mesh kit was used for the management of pelvic organ prolapse (Gynecare Prolift) in a tertiary urogynaecological centre in Singapore from January 1, 2006 to December 31, 2007.
  
  
  METHODS
  169 patients (2006 n = 95; 2007 n = 74) with total (n = 76), anterior (n = 82) and posterior (n = 11) Prolifts were followed up for two years post-surgery.
  
  
  RESULTS
  Intraoperatively, the incidence of haematoma, blood loss > 1,000 mL and blood transfusion was lower in 2007 than in 2006, although the difference was not statistically significant. One (1.4%) patient had rectal perforation in 2007. The mesh erosion rates were similar for all Prolift types (total 17.2%; posterior 14.5%; anterior 18.2%). Two patients, who had total Prolift in 2006, required mesh excision under anaesthesia for mesh extrusion. 138 (81.7%) patients were available for review at two years - nine (6.5%) patients had recurrent cystourethrocoeles and two (1.4%) had recurrent vault prolapse. Of the nine patients who had total Prolift with uterine conservation, two (1.4%) had recurrent uterine descent. The subjective cure rates two years after Prolift surgery were 98.7% for patients from 2006 and 100% for patients from 2007. The objective cure rates were 89.6% for patients from 2006 and 91.8% for patients from 2007.
  
  
  CONCLUSIONS
  Prolift mesh surgery appears to have a very high success rate for pelvic reconstructive surgery. The learning curve of the surgeon may, however, be a factor determining surgical outcome in these patients.
authors.affiliation: Urogynaecology Unit, Department of Obstetrics and Gynaecology, Hospital Tengku Ampuan Afzan, 25000 Kuantan, Pahang, Malaysia. rajfeelsgood@yahoo.com
authors.forename: Ganesh Raj
authors.initials: GR
authors.lastname: Vaiyapuri
authors.forename: How Chuan
authors.initials: HC
authors.lastname: Han
authors.forename: Lih Charn
authors.initials: LC
authors.lastname: Lee
authors.forename: Arthur Leng Aun
authors.initials: AL
authors.lastname: Tseng
authors.forename: Heng Fok
authors.initials: HF
authors.lastname: Wong
mesh_terms: D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery