title: Outcomes and complications of trans-vaginal mesh repair using the Prolift™ kit for pelvic organ prolapse at 4 years median follow-up in a tertiary referral centre.
abstract: OBJECTIVE
  To evaluate the anatomical, functional and post-operative outcomes of polypropylene mesh (Prolift™) in the surgical management of pelvic organ prolapse (POP).
  
  
  METHODS
  A single-centre observational study of 106 successive patients, who underwent Prolift™ mesh repair (POP ≥ 2) with a median follow-up of 4 years, was performed. Outcomes of interest measured included patient demographics, intra and post-operative complications, concomitant procedures for POP or urinary incontinence. Using the Baden-Walker classification, grade ≥2 prolapses in the operated compartment were deemed as surgical failure. Validated questionnaires including ICIQ-VS and ICIQ-UI were used to assess functional outcome.
  
  
  RESULTS
  Of the 106 patients, 56 had an anterior, 36 a posterior and 14 a total Prolift™. 101 patients were available for follow-up (median 4 years). 82 women underwent a clinical follow-up whilst 19 underwent a telephonic follow-up. Peri-operative bladder injury was noted in 2 (1.9 %) cases. Six (5.6 %) patients developed mesh exposure post-operatively. Re-operation rates for recurrent prolapse in the operated compartment were 2.8 % (n = 3). At follow-up, prolapse recurrence in the operated compartment was noted in another 7.3 % (n = 6) patients. Combining re-operations for POP and recurrences noted during follow-up, the revised failure rate was 10.1 % (n = 9). De novo prolapse in the non-operated compartment occurred in 19.5 % (n = 16) women.
  
  
  CONCLUSIONS
  Our study demonstrates that Prolift™ vaginal mesh surgery offers anatomical cure rates of 89.9 %. A higher rate of de novo recurrence in the non-operated compartment was noted suggesting that surgical correction in one compartment may exacerbate recurrence in other compartments.
authors: Department of Uro-gynaecology, Singleton Hospital, Abertawe Bro Morgannwg University Heath Board, Level 3, West Ward Block, Swansea, SA2 8QA, UK, zainabmallhi@yahoo.co.uk.
authors: Zainab A
authors: ZA
authors: Khan
authors: Lee
authors: L
authors: Thomas
authors: Simon J
authors: SJ
authors: Emery
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D019538:Health Care Surveys; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011126:Polypropylenes; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D014549:Urinary Incontinence / Q000209:etiology*
chemical_list: D011126:Polypropylenes