Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device

Authors: Carey; Slack¹; Higgs²; Wynn-Williams¹; Cornish²

Source: BJOG: An International Journal of Obstetrics & Gynaecology, Volume 115, Number 3, February 2008 , pp. 391-397(7)

Publisher: Wiley-Blackwell

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Abstract:

Objectives

To describe a new surgical procedure for pelvic organ prolapse using mesh and a vaginal support device (VSD) and to report the results of surgery. Design

A prospective observational study. Setting

Two tertiary referral Urogynaecology practices. Population

Ninety-five women with International Continence Society pelvic organ prolapse quantification stage 2 or more pelvic organ prolapse who underwent vaginal surgery using mesh augmentation and a VSD. Methods

Surgery involved a vaginal approach with mesh reinforcement and placement of a VSD for 4 weeks. At 6 and 12 months, women were examined for prolapse recurrence, and visual analogue scales for satisfaction were completed. Women completed quality-of-life (QOL) questionnaires preoperatively and at 6 and 12 months. Main outcome measures

Objective success of surgery at 6 and 12 months following surgery. Secondary outcomes were subjective success, complications, QOL outcomes and patients' satisfaction. Results

Objective success rate was 92 and 85% at 6 and 12 months, respectively. Subjective success rate was 91 and 87% at 6 and 12 months, respectively. New prolapse in nonrepaired compartments accounted for 7 of 12 (58%) failures at 12 months. Two of 4 mesh exposures required surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 23% at 12 months. QOL scores significantly improved at 12 months compared with baseline (P < 0.0001). Conclusion

Vaginal surgery using mesh and a VSD is an effective procedure for pelvic organ prolapse. However, further studies are required to establish the role of the surgery described in this study.

Keywords: Mesh; prolapse; vaginal support device

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2007.01606.x

Affiliations: 1: Department of Urogynaecology, Addenbrooke's Hospitals, Cambridge, UK 2: Department of Urogynaecology, Royal Women's Hospital, Melbourne, Victoria, Australia

Publication date: 2008-02-01

Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device

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