title: Efficacy and safety of skeletonized mesh implants for advanced pelvic organ prolapse: 12-month follow-up.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of skeletonized mesh implants for advanced pelvic organ prolapse (POP).
  
  
  METHODS
  Women with advances POP underwent repair of stage III or greater anterior or posterior and apical compartment prolapse using skeletonized mesh implants (Seratom PA MR MN(®) system-SERAG-WIESSNER, Naila, Germany). Anatomical outcomes were assessed using pelvic organ prolapse quantification staging and functional outcomes were self-reported by the patients at 6 weeks, 6 and 12 months. Anatomical and functional cure rates, post-operative pain and dyspareunia as well as intra and post-operative complications were reported. Success was defined as a composite of no bulge symptoms and no prolapse beyond the hymenal ring.
  
  
  RESULTS
  At 12 months, data were available for 103 of the 105 patients originally recruited. Intra-operative complications included 2 (2 %) cases of cystotomy that were corrected vaginally. The immediate post-operative complications included 1 patient (1 %) with UTI, 4 (3.9 %) cases of self-resolved hematomas, and 6 (5.8 %) cases of bladder outlet obstruction. At 12 months, a high success rate and low complication rate was noted. Recurrence of prolapse was reported by 7 (6.6 %) patients. However, only 4 (3.8 %) underwent a repeat procedure. Two patient developed de novo SUI, and 6 (5.7 %) developed dyspareunia. No cases of mesh erosion/extrusion were noted.
  
  
  CONCLUSIONS
  The present study showed excellent anatomical and quality of life results in patients with advanced POP treated with a skeletonized and reduced mesh system. No mesh exposure was recorded within the first year after surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. adiyehud@bgu.ac.il.
authors.forename: Adi Y
authors.identifier: http://orcid.org/0000-0002-4239-8665
authors.initials: AY
authors.lastname: Weintraub
authors.affiliation: Urogynecology, Department of Obstetrics and Gynecology, Galilee Medical Center, Affiliated with Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel.|Assuta Medical Centers, Tel Aviv, Rishon LeZion, Israel.
authors.forename: Menahem
authors.initials: M
authors.lastname: Neuman
authors.affiliation: Division of Community Health, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Yonatan
authors.initials: Y
authors.lastname: Reuven
authors.affiliation: Department of Urology, Charitè University, Berlin, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Neymeyer
authors.affiliation: Department of Obstetrics and Gynecology, Ziv Medical Center, Affiliated with Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel.
authors.forename: Naama
authors.initials: N
authors.lastname: Marcus-Braun
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome
keywords: Mesh augmentation; Pelvic organ prolapse; Sacrospinous ligament fixation; Skeletonized mesh