title: Clinical Outcomes and Urodynamic Effects of Tailored Transvaginal Mesh Surgery for Pelvic Organ Prolapse.
abstract: OBJECTIVE
  To evaluate the clinical outcomes and urodynamic effects of tailored anterior transvaginal mesh surgery (ATVM) and tailored posterior transvaginal mesh surgery (PTVM).
  
  
  METHODS
  We developed ATVM for the simultaneous correction of cystocele and stress urinary incontinence and PTVM for the simultaneous correction of enterocoele, uterine prolapse, vaginal stump prolapse, and rectocele.
  
  
  RESULTS
  A total of 104 women enrolled. The median postsurgical follow-up was 25.5 months. The anatomic cure rate was 98.1% (102/104). Fifty-eight patients underwent urodynamic studies before and after surgeries. The pad weight decreased from 29.3 ± 43.1 to 6.4 ± 20.9 g at 3 months. Among the 20 patients with ATVM, 13 patients had objective stress urinary incontinence (SUI) at baseline while 8 patients came to have no demonstrated SUI (NDSUI), and 2 improved after surgery. Among the 38 patients who underwent ATVM and PTVM, 24 had objective SUI at baseline while 18 came to have NDSUI, and 2 improved after surgery. Mesh extrusion (n = 4), vaginal hematoma (n = 3), and voiding difficulty (n = 2) were noted postoperatively. Quality of life was substantially improved.
  
  
  CONCLUSIONS
  Our findings document the advantages of these two novel pelvic reconstructive surgeries for pelvic organ prolapse, which had a positive impact on quality of life. ATVM surgery additionally provided an anti-incontinence effect. This clinical trial is registered at ClinicalTrials.gov (NCT02178735).
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine and National Taiwan University Hospital, National Taiwan University, 8 Chung-Shan South Road, Taipei 10041, Taiwan.
authors.forename: Ting-Chen
authors.initials: TC
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, 21 Section 2, Nanya South Road, Banqiao District, New Taipei 20060, Taiwan.
authors.forename: Sheng-Mou
authors.initials: SM
authors.lastname: Hsiao
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine and National Taiwan University Hospital, National Taiwan University, 8 Chung-Shan South Road, Taipei 10041, Taiwan.
authors.forename: Chi-Hau
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, 21 Section 2, Nanya South Road, Banqiao District, New Taipei 20060, Taiwan.
authors.forename: Wen-Yih
authors.initials: WY
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine and National Taiwan University Hospital, National Taiwan University, 8 Chung-Shan South Road, Taipei 10041, Taiwan.
authors.forename: Ho-Hsiung
authors.initials: HH
authors.lastname: Lin
mesh_terms: D019544:Equipment Failure Analysis; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011788:Quality of Life; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics