title: Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 5-year prospective follow-up study.
abstract: OBJECTIVE
  To evaluate clinical effectiveness and complication rates at 5 years following the total Trans Vaginal Mesh (TVM) technique to treat pelvic organ prolapse.
  
  
  METHODS
  Prospective, observational, multi-centre study in patients with prolapse of stage II or higher.
  
  
  RESULTS
  Of the 90 women enrolled in the study, 82 (91%) were available for the 5-year follow-up period. At the 5-year endpoint, success, defined as no surgical prolapse reintervention and leading edge <-1 (International Continence Society [ICS] criteria) or above the level of the hymen, was 79% and 87% respectively. A composite criterion of success defined as: leading edge above the hymen (<0) and no bulge symptoms and no reintervention for prolapse was met by 90%, 88% and 84% at the 1-, 3-, and 5-year endpoints respectively. Quality of life improvement was sustained over the 5 years. Over the 5-year follow-up period, a total of only 4 patients (5%) required re-intervention for prolapse, while a total of 14 patients (16%) experienced mesh exposure for which 8 resections needed to be performed. Seven exposures were still ongoing at the 5-year endpoint, all asymptomatic. Only 33 out of 61 (54%) sexually active patients at baseline remained so at 5 years. De novo dyspareunia was reported by 10%, but no new cases at the 5-year endpoint. One patient reported de novo unprovoked mild pelvic pain at 5 years, 5 reported pains during pelvic examination only.
  
  
  CONCLUSIONS
  Five-year results indicated that TVM provided a stable anatomical repair. Improvements in QOL and associated improvements in prolapse-specific symptoms were sustained. Minimal new morbidity emerged between the 1- and 5-year follow-up.
authors.affiliation: Department of Obstetrics and Gynaecology, Estaing University Hospital, Clermont-Ferrand, France, bjacquetin@chu-clermontferrand.fr.
authors.forename: B
authors.initials: B
authors.lastname: Jacquetin
authors.forename: P
authors.initials: P
authors.lastname: Hinoul
authors.forename: J
authors.initials: J
authors.lastname: Gauld
authors.forename: B
authors.initials: B
authors.lastname: Fatton
authors.forename: C
authors.initials: C
authors.lastname: Rosenthal
authors.forename: H
authors.initials: H
authors.lastname: Clavé
authors.forename: O
authors.initials: O
authors.lastname: Garbin
authors.forename: J
authors.initials: J
authors.lastname: Berrocal
authors.forename: R
authors.initials: R
authors.lastname: Villet
authors.forename: D
authors.initials: D
authors.lastname: Salet-Lizée
authors.forename: P
authors.initials: P
authors.lastname: Debodinance
authors.forename: M
authors.initials: M
authors.lastname: Cosson
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013526:Surgical Mesh; D016896:Treatment Outcome
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