title: Prospective long-term results, complications and risk factors in pelvic organ prolapse treatment with vaginal mesh.
abstract: OBJECTIVE
  To assess the long-term results and complications of pelvic organ prolapse treatment with transvaginal mesh.
  
  
  METHODS
  Prospective observational study of 75 women who underwent surgery between 2005 and 2008 by the same surgeon. 44 patients (58,7%) underwent concomitant treatment of stress urinary incontinence. Anatomical criterion for failure was prolapse grade >I in any compartment. Analysis of functional features consisted of an assessment of urinary, sexual, and defecation symptoms, and pelvic pain. Subjective global evaluation of the treatment was carried out through the Visual Analogue Scale (VAS). Analysis of the early and late complications and their medical or surgical management was performed. Evaluation of risk factors for failure of treatment and extrusion was carried out through logistic regression.
  
  
  RESULTS
  The median follow-up was 5,3 years. The anatomical results showed correction in 91,3% of the patients. Median subjective VAS evaluation: 9/10. Urinary symptoms improved after the surgery. Constipation and dyspareunia rates worsened. Pelvic pain improved. There were two early complications: one rectal perforation, repaired intraoperatively and one pulmonary embolism, managed medically. Late complications: 9 extrusions (3 managed with topical oestrogen, 3 with expectant management, and 3 reoperated, one twice), one cervix elongation and one forgotten gauze (both reoperated), 4 de novo pain managed successfully conservatively. 58,8% of the complications occurred after one year. Risk factors analyzed showed no statistical significance.
  
  
  CONCLUSIONS
  Vaginal mesh provides favorable anatomical, functional and subjective outcomes in long-term follow-up. The number of complications is relatively low, but many complications occurred a long-time after surgery.
authors.affiliation: Urology Department, Ramón y Cajal University Hospital, Alcalá University, Madrid, Spain. Electronic address: ines.laso.garcia@gmail.com.
authors.forename: Inés M
authors.initials: IM
authors.lastname: Laso-García
authors.affiliation: Urology Department, Ramón y Cajal University Hospital, Alcalá University, Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rodríguez-Cabello
authors.affiliation: Urology Department, Ramón y Cajal University Hospital, Alcalá University, Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Jiménez-Cidre
authors.affiliation: Urology Department, Ramón y Cajal University Hospital, Alcalá University, Madrid, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Orosa-Andrada
authors.affiliation: Urology Department, Ramón y Cajal University Hospital, Alcalá University, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Carracedo-Calvo
authors.affiliation: Urology Department, Ramón y Cajal University Hospital, Alcalá University, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: López-Fando
authors.affiliation: Urology Department, Ramón y Cajal University Hospital, Alcalá University, Madrid, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Burgos-Revilla
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000209:etiology; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
keywords: Complications; Pelvic organ prolapse; Results; Risk factors