title: Quality of life in women of non-reproductive age with transvaginal mesh repair for pelvic organ prolapse: A cohort study.
abstract: BACKGROUND
  Transvaginal mesh repair has been discredited due to high complications rates in the past years. Therefore, we evaluated the quality of life (QoL) and complication rates after transvaginal mesh (TVM) repair for pelvic organ prolapse (POP).
  
  
  METHODS
  A total of 148 women who underwent TVM repair for symptomatic POP were retrospectively enrolled. Complication rates and functional outcomes were retrospectively assessed and validated, standardised questionnaires were used prospectively for evaluation of QoL. Univariate analysis by the chi(2)-test as well as a multivariate Cox regression analysis was conducted to predict mesh exposure using various variables as predictors.
  
  
  RESULTS
  Intraoperative complications with bowel or bladder injury appeared in 3.4%. Mesh exposure occurred in 2.7% whereas surgical revision was necessary only in 1.4%. No predictor for mesh exposure could be identified. Postoperative complications according to Clavien-Dindo classification ≥ III occurred in only 2.8%. An improvement of POP-symptoms was reported by 84.6% according the "patients' global impression of improvement" (PGI-I) and 88.2% women would repeat the surgery. The results of the "prolapse-quality of life"-questionnaire were comparable to asymptomatic women. Only 33% reported vaginal pain with a mean vaginal pain score of 0.6 according the international index of pain. Of sexually active women, 29% reported sexual impairments and mean score of sexual impairment was 1.52.
  
  
  CONCLUSIONS
  Low complication rates and a quality of life comparable to asymptomatic women following TVM repair could be achieved in our cohort. However, a high number of sexual impairments was identified although the impact of impairment was marginal.
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Mainz, Mainz, Germany. Electronic address: tanjahuesch@gmail.com.
authors.forename: Tanja
authors.initials: T
authors.lastname: Hüsch
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Mainz, Mainz, Germany.
authors.forename: René
authors.initials: R
authors.lastname: Mager
authors.affiliation: Gynecological Practice, Michelstadt, Germany.
authors.forename: Erika
authors.initials: E
authors.lastname: Ober
authors.affiliation: Gynecological Practice, Michelstadt, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Bentler
authors.affiliation: Institute of Medical Statistic and Epidemiology, Technical University Munich, Munich, Germany.
authors.forename: Kurt
authors.initials: K
authors.lastname: Ulm
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Mainz, Mainz, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Haferkamp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects*; D011788:Quality of Life; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014945:Wound Healing
keywords: Pelvic organ prolapse; Quality of life; Transvaginal mesh repair; Vaginal surgery