title: Long-term outcome after transvaginal mesh repair of pelvic organ prolapse.
abstract: OBJECTIVE
  The aim of this study was to report long-term subjective and objective outcomes after the transvaginal mesh (TVM) procedure in long-term. Possible late-onset complications were of particular interest.
  
  
  METHODS
  This was a retrospective analysis of TVM performed using Prolift™ transvaginal mesh measuring subjective outcome using validated questionnaires. Objective outcome was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system using two definitions: POP-Q stage ≤ 1, and vaginal wall prolapse at or above the hymen or vaginal apex not descending below the upper third of the vagina. Complications were reported with the Prosthesis/Graft Complication Classification Code designed by the International Continence Society/International Urogynecological Association (ICS/IUGA).
  
  
  RESULTS
  Of 195 patients, 161 (82.6 %) participated this study after a median of 7 years. The scores in questionnaires evaluating urinary (UI) or anal incontinence and constipation or pelvic floor symptoms were low, indicating favorable surgical outcomes. Altogether, 80.1 % of patients were satisfied with the procedure. Anatomical cure was 56.4 % and 69.3 % depending on the definition used. Reoperation due to POP in any compartment was performed in 16.2 % of patients. Mesh exposure rate was 23 %, most of these being asymptomatic and of late onset.
  
  
  CONCLUSIONS
  Outcome of the TVM procedure was satisfactory. Anatomical cure was inferior to subjective cure. Mesh exposure rate was high; most exposures observed in the long-term were of late onset and were asymptomatic.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland. pia.heinonen@tyks.fi.
authors.forename: Pia
authors.identifier: http://orcid.org/0000-0003-3325-865X
authors.initials: P
authors.lastname: Heinonen
authors.affiliation: Department of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.
authors.forename: Riikka
authors.initials: R
authors.lastname: Aaltonen
authors.affiliation: Department of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Joronen
authors.affiliation: Department of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.
authors.forename: Seija
authors.initials: S
authors.lastname: Ala-Nissilä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data*; D006801:Humans; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects
keywords: Complications; Long-term follow-up; Mesh exposure; Pelvic organ prolapse; Subjective outcome; Transvaginal mesh
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