title: Two years follow up of 270 patients treated by transvaginal mesh for anterior and/or apical prolapse.
abstract: OBJECTIVE
  The aim of this study was to assess the 1 and 2 years outcomes of transvaginal single incision mesh surgery (SIMS) for anterior pelvic organ prolapse (POP).
  
  
  METHODS
  This was a prospective study including all patients from November 2008 to December 2012 who underwent SIMS for symptomatic anterior prolapse stage≥2, according to the POP Quantification (POP-Q). Symptoms and quality of life were assessed using validated questionnaires: Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact questionnaire (PFIQ-7), and Prolapse/Incontinence Sexual Questionnaire (PISQ-12). The main outcome was subjective success (question 3 of PFDI-20 score=0). Safety, anatomic and functional outcomes were used as the secondary outcomes.
  
  
  RESULTS
  A total of 270 patients were included in the study. Subjective success rate was 95,4% and 92,2% at 1 and 2 years. Objective success rate was 65,9%and 60,5% at 1 and 2 years. At 1year, composite failure (subjective+objective) occurred for 11 patients (4,6%), 5 patients with direct recurrence and 6 with indirect recurrence. At 2 years, composite failure was reported for 14 patients (6,4%): 6 direct recurrences and 8 indirect recurrences. Re-treatment was performed in one case (0,4%). One case (0,4%) of asymptomatic mesh exposure occurred. The reoperation rate for mesh-related complications was 3%. We reported a de novo dyspareunia rate of 8,4%, 5,3% considered as mesh-related. A significant improvement was noted for symptoms and quality of life.
  
  
  CONCLUSIONS
  POP repair using SIMS is a safe and efficient treatment of anterior compartment prolapse in the medium term with a low rate of mesh-related complications. Longer-term follow-up is ongoing.
authors.affiliation: Clinique Beau Soleil, Montpellier, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Hugele
authors.affiliation: Clinique Beau Soleil, Montpellier, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Panel
authors.affiliation: Kantonsspital Winterthur, Switzerland.
authors.forename: Camille
authors.initials: C
authors.lastname: Farache
authors.affiliation: Hôpital du Jura bernois, Saint Imier, Switzerland.
authors.forename: Amgad
authors.initials: A
authors.lastname: Kashef
authors.affiliation: Clinique Beau Soleil, Montpellier, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Cornille
authors.affiliation: Clinique Beau Soleil, Montpellier, France. Electronic address: c.courtieu@languedoc-mutualite.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Courtieu
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004414:Dyspareunia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000503:physiopathology; D059952:Pelvic Floor Disorders / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D056887:Pelvic Organ Prolapse / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation / Q000009:adverse effects; D012307:Risk Factors; D055502:Secondary Prevention; D057566:Self Report; D012720:Severity of Illness Index; D013526:Surgical Mesh / Q000009:adverse effects*; D017211:Treatment Failure
keywords: Dyspareunia; Pelvic organ prolapse; Polypropylene mesh; Vaginal surgery