title: Medium-term comparison of uterus preservation versus hysterectomy in pelvic organ prolapse treatment with Prolift™ mesh.
abstract: OBJECTIVE
  We conducted a medium-term assessment of clinical outcomes and complications after surgical repair of pelvic organ prolapse (POP) using Prolift™ mesh, and sought to determine whether concomitant hysterectomy clinically influenced the outcome of pelvic reconstruction in patients without a prior history of urogenital surgery.
  
  
  METHODS
  Patients diagnosed with POP-Q stage 3/4 uterine prolapse at a tertiary referral urogynecology unit in South Taiwan who had undergone POP repair with Prolift mesh from May 2007 to July 2010 were identified by chart review. Concomitant hysterectomy was performed in 24 patients (hysterectomy group), and uterus-sparing surgery in 78 (uterus-sparing group) Preoperative and postoperative subjective assessments of urinary and prolapse symptoms, objective POP-Q score, urodynamic examination, and postoperative adverse events were compared between the groups.
  
  
  RESULTS
  The mean follow-up periods were 25.7 months (range 6.2 - 73.1 months) and 31.7 months (range 6.0 - 78.4 months) in the concomitant hysterectomy and uterus-sparing groups, respectively. There were no between-group differences in functional and anatomic outcomes after surgery. No statistically significant differences were found in postoperative adverse events between the groups.
  
  
  CONCLUSIONS
  Pelvic reconstruction using Prolift with concomitant hysterectomy and uterus-sparing surgery have similar anatomic and functional results at 2.5 years. Therefore, we consider uterus-sparing surgery to be an alternative to hysterectomy in uterine prolapse repair.
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niao-Sung Dist., Kaohsiung, Taiwan, 83301.
authors.forename: Li-Yi
authors.initials: LY
authors.lastname: Huang
authors.forename: Li-Ching
authors.initials: LC
authors.lastname: Chu
authors.forename: Hsin-Ju
authors.initials: HJ
authors.lastname: Chiang
authors.forename: Fei-Chi
authors.initials: FC
authors.lastname: Chuang
authors.forename: Fu-Tsai
authors.initials: FT
authors.lastname: Kung
authors.forename: Kuan-Hui
authors.initials: KH
authors.lastname: Huang
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D013526:Surgical Mesh