Abstract

SANTOS, Fernanda; DUARTE, Isabel; CORREIA, António  and  SANTIAGO, António. Transvaginal repair of genital prolapse with a Prolift system: complications and outcomes after 7 years of follow-up. Acta Obstet Ginecol Port [online]. 2018, vol.12, n.3, pp.182-189. ISSN 1646-5830.

Overview: Transvaginal mesh (TM) procedures has revolutionized the pelvic organ prolapse treatment. Although high success, since 2008 US Food and Drug Administration alert about potential complications that conduct to withdrawn from the market of several mesh systems. Aim: To report long-term outcomes after a polypropylene mesh (Ethicon Gynecare ProliftTM) procedure. Study Design: Cross-Sectional Study Methods: It was performed a retrospective analysis of 54 women submitted to Prolift transvaginal mesh, at Urogynecology department of Centro Hospitalar de Leiria, between January 2009 to January 2017. Outcome was assessed using the Pelvic Organ Prolapse Quantification system and complications were reported with the Prosthesis Complication Classification Code designed by the International Continence Society/International Urogynecological Association. Anatomic failure was defined as recurrent prolapse (grade≥2), at the same compartment. Statistical analysis was performed with STATA 13.1 (significance if p < 0.05). Results: Fifty-four menopausal women were followed at a median time of four years (1-7). Eighty-one percent had more than two vaginal deliveries and 70% were obese (BMI >= 30 kg/m2). Ninety-one percent had POP stage higher than 2. Total mesh was done in 10 patients (19%), isolated anterior mesh in 40 (74%) and isolated posterior mesh in 4 patients (7%). Complications happened in nine patients (17%). We reported five anatomic failures (overall success of 91%). We found statistical association between failure, POP grade and type of mesh repair. (p<0.05). Conclusions: The Prolift transvaginal mesh system seems to be associated with mild complications and a high overall success.

Keywords : Surgical mesh; Pelvic organ prolapse; Complications; Treatment outcome.

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