title: Utero-vaginal suspension using bilateral vaginal anterior sacrospinous fixation with mesh: intermediate results of a cohort study.
abstract: OBJECTIVE
  Pelvic organ prolapse is a major burden for the public health system, affecting up to 30 % of all women. One mesh kit has been introduced for pelvic organ prolapse surgery that can be inserted via a single anterior incision with the mesh arms driven through the sacrospinous ligament in a tension-free manner. The aim of this study was to describe the medium-term results of this vaginal mesh kit procedure for the combined treatment of the anterior vaginal wall and vault prolapse.
  
  
  METHODS
  This is a longitudinal case series of patients undergoing an anterior mesh operation between 2009 and 2013. All patients presenting with symptomatic stage II prolapse or higher were included when a minimum follow-up of 12 months was achieved. A structured interview and clinical examination were performed pre- and postoperatively.
  
  
  RESULTS
  One hundred and eighteen consecutive patients were operated with the Uphold® system during the study period. Three patients did not complete the 12-month follow-up and were excluded from the analysis, leaving 115 patients. Anatomical success at a mean follow-up of 23 months was 93 %, with a patient satisfaction rate of 95 %. Four patients (8 %) experienced de novo dyspareunia related to the mesh. The reoperation rate for mesh-related complications was 3.4 %; no patients were re-operated for POP recurrence.
  
  
  CONCLUSIONS
  The subjective and objective cure rates were high and the mesh-related re-operation rate was 3 % in the medium term, suggesting that this surgical technique may be an option for women requiring anterior and apical prolapse repair.
authors.affiliation: Department of Obstetrics and Gynaecology, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Letouzey
authors.affiliation: Department of Obstetrics and Gynaecology, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France. daniela.ulrich.at@gmail.com.|Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria. daniela.ulrich.at@gmail.com.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ulrich
authors.affiliation: Department of Obstetrics and Gynaecology, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France.
authors.forename: Eva
authors.initials: E
authors.lastname: Balenbois
authors.affiliation: Department of Obstetrics and Gynaecology, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Cornille
authors.affiliation: Department of Obstetrics and Gynaecology, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: de Tayrac
authors.affiliation: Department of Obstetrics and Gynaecology, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Fatton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007512:Ischium; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D010298:Parity; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012447:Sacrum; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome
keywords: Dyspareunia; Pelvic organ prolapse; Sacrospinous ligament; Tension-free; Uphold®