Posterior Transvaginal Mesh without Concurrent Surgery: How Does It Have an Effect on the Untreated Vaginal Compartment?

作者：Nyyssonen Virva^*; Santala Markku; Ala Nissila Seija; Bloigu Risto; Haarala Mervi

来源：Gynecologic and Obstetric Investigation, 2017, 82(1): 66-71.

DOI：10.1159/000445742

• Transvaginal mesh
• Posterior prolapse
• De novo prolapse

Background/Aims: To report objective and subjective outcomes and adverse events after placement of Elevate Posterior transvaginal mesh without concurrent surgery. Changes in non-affected anterior compartment were under special interest. Methods: A prospective study of Elevate Posterior procedure in patients with symptomatic posterior compartment prolapse. Pelvic organ prolapse (POP) quantification (POP-Q) measurements and Pelvic Floor Dysfunction Inventory -20 (PFDI-20) and POP/urinary Incontinence Sexual Questionnaire (PISQ-12) questionnaires were used. Primary outcome was the incidence of de novo anterior prolapse. Secondary outcomes were complication rate and posterior compartment objective and subjective cure. Results: A total of 111 women underwent an Elevate Posterior mesh procedure and 109 attended a control visit at 3 months. De novo anterior prolapse emerged in 3.2-15% of the women, depending on the definition. Posterior POP-Q stage was obtained in 92 (84%) women and leading edge at or above the hymen in 107 (98%) women. Bulge symptoms disappeared in 86% of the cases. One (0.9%) mesh exposure was detected. Reoperation rate was 2.8, and 3.7% patients experienced postoperative pain. PFDI-20 and PISQ-12 scores improved significantly. Conclusions: A trend of de novo prolapse formation in the non-affected vaginal compartment is observed. The Elevate Posterior method is effective in terms of both objective and subjective outcomes. According to our results, the mesh exposure rate is low.

• 出版日期2017