title: Posterior Transvaginal Mesh without Concurrent Surgery: How Does It have an Effect on the Untreated Vaginal Compartment?
abstract: OBJECTIVE
  To report objective and subjective outcomes and adverse events after placement of Elevate® Posterior transvaginal mesh without concurrent surgery. Changes in non-affected anterior compartment were under special interest.
  
  
  METHODS
  A prospective study of Elevate® Posterior procedure in patients with symptomatic posterior compartment prolapse. Pelvic organ prolapse (POP) quantification (POP-Q) measurements and Pelvic Floor Dysfunction Inventory-20 (PFDI-20) and POP/urinary Incontinence Sexual Questionnaire (PISQ-12) questionnaires were used. Primary outcome was the incidence of de novo anterior prolapse. Secondary outcomes were complication rate and posterior compartment objective and subjective cure.
  
  
  RESULTS
  A total of 111 women underwent an Elevate® Posterior mesh procedure and 109 attended a control visit at 3 months. De novo anterior prolapse emerged in 3.2-15% of the women, depending on the definition. Posterior POP-Q stage ≤I was obtained in 92 (84%) women and leading edge at or above the hymen in 107 (98%) women. Bulge symptoms disappeared in 86% of the cases. One (0.9%) mesh exposure was detected. Reoperation rate was 2.8, and 3.7% patients experienced postoperative pain. PFDI-20 and PISQ-12 scores improved significantly.
  
  
  CONCLUSIONS
  A trend of de novo prolapse formation in the non-affected vaginal compartment is observed. The Elevate® Posterior method is effective in terms of both objective and subjective outcomes. According to our results, the mesh exposure rate is low.
authors.affiliation: Department of Obstetrics and Gynecology, North Karelia Central Hospital, Joensuu, Finland.
authors.forename: Virva
authors.initials: V
authors.lastname: Nyyssönen
authors.forename: Markku
authors.initials: M
authors.lastname: Santala
authors.forename: Seija
authors.initials: S
authors.lastname: Ala-Nissilä
authors.forename: Risto
authors.initials: R
authors.lastname: Bloigu
authors.forename: Mervi
authors.initials: M
authors.lastname: Haarala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000209:etiology / Q000601:surgery*; D011126:Polypropylenes / Q000009:adverse effects; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects*; D053825:Suburethral Slings / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014621:Vagina / Q000601:surgery*
chemical_list: D001672:Biocompatible Materials; D011126:Polypropylenes