title: Comparison between Elevate anterior/apical system and Perigee system in pelvic organ prolapse surgery: clinical and sonographic outcomes.
abstract: OBJECTIVE
  The aim of this study was to assess the incidence of de novo stress urinary incontinence (SUI) and sonographic features of implanted transvaginal mesh in continent women treated with Elevate(™) anterior/apical [single-incision mesh (SIM-A)] or Perigee(™) [transvaginal mesh with sacrospinous fixation (TVM + SSF)] in extensive pelvic organ reconstruction surgery.
  
  
  METHODS
  This prospective observational study was done from May 2010 to January 2013. Patients were recruited from two tertiary centers, and the Elevate(™) and Perigee(™) systems were compared. Patients who had overt or occult SUI, previous prolapse or mesh insertion were excluded.
  
  
  RESULTS
  Fifty-seven patients in the SIM-A group and sixty-one in the TVM + SSF group were analysed. All completed a minimum of 1-year follow-up. Groups were demographically and statistically similar. There was a significantly high incidence of de novo SUI postoperatively in the SIM-A group. The objective and subjective cure rate of pelvic organ prolapse (POP) were comparable between groups, with incidence of mesh erosion in the SIM-A group and three in the TVM + SSF group. Sonographic evaluation showed significant increase in mesh length in the SIM-A group.
  
  
  CONCLUSIONS
  Elevate(™) a offered lower incidence of mesh erosion and comparable results on anatomical POP correction; however, incidence of de novo SUI was high. There is an apparent lengthening of implanted Elevate® mesh sonographically.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Keelung, Keelung Medical Center, Keelung, Taiwan, Republic of China, 2378@cgmh.org.tw.
authors.forename: Tsia-Shu
authors.initials: TS
authors.lastname: Lo
authors.forename: Nazura
authors.initials: N
authors.lastname: Bt Karim
authors.forename: Eileen Feliz M
authors.initials: EF
authors.lastname: Cortes
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Wu
authors.forename: Yi-Hao
authors.initials: YH
authors.lastname: Lin
authors.forename: Yiap Loong
authors.initials: YL
authors.lastname: Tan
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D011446:Prospective Studies; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics