title: Long-term functional outcomes following mesh-augmented posterior vaginal prolapse repair.
abstract: OBJECTIVE
  To assess long-term patient-centered functional outcomes following posterior vaginal wall repair using mesh implants.
  
  
  METHODS
  The present prospective telephone interview study enrolled a cohort of women who had undergone posterior vaginal wall repair with mesh between January 1, 2006 and February 28, 2009, at a single center in Israel. Patients were asked to report long-term outcomes, and demographic, clinical, intraoperative, and postoperative follow-up data were retrieved from patients' medical files. Multivariable logistic regression models were used to asses associations between baseline characteristics and long-term outcomes.
  
  
  RESULTS
  In total, 102 patients were contacted, with 80 (78.4%) at 61-83months after surgery agreeing to participate. A recurrence of prolapse symptoms was reported by 14 patients (18%) (12 required a corrective procedure), mesh had been removed from two patients owing to erosion/extrusion, and two others had undergone removal of granulation tissue. Long-term, bothersome symptoms were reported by 13 (16%) patients. Parity and previous hysterectomy were associated with lower odds of long-term adverse outcomes, and the location of the apical (C/D) pelvic organ prolapse quantification point and a change in its position following surgery were associated with increased odds of adverse outcomes.
  
  
  CONCLUSIONS
  The long-term adverse-outcome rate was low for patients who underwent posterior vaginal mesh augmentation. These results highlight the importance of apical support for good long-term functional outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel.
authors.forename: Adi Y
authors.initials: AY
authors.lastname: Weintraub
authors.affiliation: Assuta Medical Centers, Tel Aviv and Rishon LeZion, Israel.
authors.forename: Talia
authors.initials: T
authors.lastname: Friedman
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Baumfeld
authors.affiliation: Department of Urology, Charitè University, Berlin, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Neymeyer
authors.affiliation: Assuta Medical Centers, Tel Aviv and Rishon LeZion, Israel; Urogynecology, Department of Obstetrics and Gynecology, Galilee Hospital, Center, affiliated with Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel.
authors.forename: Menahem
authors.initials: M
authors.lastname: Neuman
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: haimkr@clalit.org.il.
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007557:Israel; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data*; D013526:Surgical Mesh; D014549:Urinary Incontinence / Q000150:complications / Q000453:epidemiology; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery
keywords: Apical support; Long-term functional outcomes; Mesh augmentation; Posterior vaginal prolapse; Recurrent-prolapse surgery