Single-incision mesh repair versus traditional native tissue repair for pelvic organ prolapse: results of a cohort study.
OBJECTIVE
To compare the efficacy and safety of the Elevate™ anterior and posterior prolapse repair system and traditional vaginal native tissue repair in the treatment of stage 2 or higher pelvic organ prolapse.


METHODS
A cohort study was conducted between January 2010 and July 2012. Patients who underwent transvaginal pelvic reconstruction surgery for prolapse were recruited. The primary outcome was anatomical success 1 year after surgery. The secondary outcome included changes in the quality of life and surgical complications. Recurrence of prolapse was defined as stage 2 or higher prolapse based upon the pelvic organ prolapse qQuantification system.


RESULTS
Two hundred and one patients (100 in the Elevate™ repair group and 101 in the traditional repair group) were recruited and analyzed. The anatomical success rate of the anterior compartment was significantly higher in the Elevate™ repair group than in the traditional repair group (98 % vs 87 %, p = 0.006), but not for the apical (99 % vs. 6 %, p = 0.317) or posterior (100 % vs 97 %, p = 0.367) compartments after a median 12 months of follow-up. Both groups showed significant improvements in the quality of life after surgery with no statistical difference. Mesh-related complications included extrusion (3 %) and the need for revision of the vaginal wound (1 %). Those in the mesh repair group had a longer hospital stay (p = 0.04), operative time (p < 0.001), and greater estimated blood loss (p = 0.05). Other complications were comparable with no statistical difference.


CONCLUSIONS
The Elevate™ prolapse repair system had a better 1-year anatomical cure rate of the anterior compartment than traditional repair, with slightly increased morbidity.
Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, drthsu@mail.itrip.com.tw.
Tsung-Hsien
TH
Su
Hui-Hsuan
HH
Lau
Wen-Chu
WC
Huang
Ching-Hung
CH
Hsieh
Rhu-Chu
RC
Chang
Chin-Hui
CH
Su
D000368:Aged; D016063:Blood Loss, Surgical; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D056887:Pelvic Organ Prolapse / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh / Q000009:adverse effects; D014621:Vagina / Q000473:pathology / Q000601:surgery*