title: Tension-free polypropylene mesh-related surgical repair for pelvic organ prolapse has a good anatomic success rate but a high risk of complications.
abstract: BACKGROUND
  Food and Drug Administration announcements have highlighted the standard rate of mesh-related complications. We aimed to report the short-term results and complications of tension-free polypropylene mesh (PROSIMA™) surgical repair of pelvic organ prolapse (POP) using the standard category (C), timing (T), and site (S) classification system.
  
  
  METHODS
  A prospective cohort study of 48 patients who underwent PROSIMA™ mesh kit-related surgical repairs were followed for two years at Peking Union Medical College Hospital. Recurrence was defined as symptomatic POP quantification (POP-Q) Stage II or higher (leading edge ≥ -1 cm). The Patient Global Impression of Change Questionnaire, the Chinese version of the Pelvic Floor Impact Questionnaire short-form-7 and POP/Urinary Incontinence Sexual Questionnaire short-form-12 were used to evaluate the self-perception and sexual function of each patient. Mesh-related complications conformed to the International Urogynecological Association/International Continence Society joint terminology. The paired-sample t-test, one-way analysis of variance, Fisher's exact test, Kaplan-Meier survival analysis and log-rank test were used to analyze data.
  
  
  RESULTS
  All patients were followed up for ≥12 months; 30 (62.5%) patients completed the 24 months study. We observed a 93.8% (45/48) positive anatomical outcome rate at 12 months and 90.0% (27/30) at 24 months. Recurrence most frequently involved the anterior compartment (P < 0.05). Pelvic symptoms improved significantly from baseline (P < 0.05), although the patients' impressions of change and sexual function were not satisfying. Vaginal complication was the main complication observed (35.4%, 17/48). The survival analysis did not identify any relationship between vaginal complication and anatomical recurrent prolapse (POP-Q ≥ Stage II) (P = 0.653).
  
  
  CONCLUSIONS
  Tension-free polypropylene mesh (PROSIMA™ )-related surgical repair of POP has better short-term anatomical outcomes at the apical and posterior compartments, but a low patient satisfaction rate. The mesh complications were not the definitive cause of recurrence.
authors: Lei
authors: L
authors: Zhang
authors: Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Lan
authors: L
authors: Zhu
authors: Juan
authors: J
authors: Chen
authors: Tao
authors: T
authors: Xu
authors: Jing-He
authors: JH
authors: Lang
mesh_terms: D000368:Aged; D015331:Cohort Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011126:Polypropylenes / Q000737:chemistry*; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh
chemical_list: D011126:Polypropylenes
references: Int Urogynecol J Pelvic Floor Dysfunct. 2007 Nov;18(11):1297-302
references: 17347790
references: Int Urogynecol J. 2012 Aug;23(8):1027-33
references: 22398825
references: Obstet Gynecol. 2012 Mar;119(3):539-46
references: 22353951
references: Am J Obstet Gynecol. 1996 Jul;175(1):10-7
references: 8694033
references: Obstet Gynecol. 2011 Feb;117(2 Pt 1):242-50
references: 21252735
references: Int Urogynecol J. 2011 Jan;22(1):3-15
references: 21140130
references: Int Urogynecol J. 2011 Dec;22(12):1529-34
references: 21822714
references: Int J Gynaecol Obstet. 2012 Feb;116(2):117-9
references: 22079198
references: Eur J Obstet Gynecol Reprod Biol. 2013 May;168(1):107-11
references: 23298899
references: Menopause. 2011 Sep;18(9):1030-3
references: 21587092
references: Int Urogynecol J. 2012 Jan;23(1):5-9
references: 22086260
references: Int Urogynecol J. 2012 Apr;23(4):487-93
references: 22143448
references: Int Urogynecol J. 2011 Jul;22(7):789-98
references: 21424785
references: Am J Obstet Gynecol. 2002 Jun;186(6):1160-6
references: 12066091
references: Hong Kong Med J. 2013 Dec;19(6):511-7
references: 23784533
references: Am J Obstet Gynecol. 1999 Jul;181(1):6-11
references: 10411783
references: Am J Obstet Gynecol. 2010 Dec;203(6):587.e1-8
references: 20934681
references: Am J Obstet Gynecol. 2010 Dec;203(6):590.e1-7
references: 20863479
references: Am J Obstet Gynecol. 2004 Nov;191(5):1533-8
references: 15547521
references: BJOG. 2008 Feb;115(3):391-7
references: 18190377
references: Indian J Urol. 2012 Apr;28(2):129-53
references: 22919127
references: Am J Obstet Gynecol. 2005 Mar;192(3):780-8
references: 15746672
references: Proc R Soc Med. 1969 Oct;62(10):989-93
references: 4899510