Transvaginal mesh surgery for pelvic organ prolapse: one-year outcome analysis
Journal of Gynecologic Surgery
Objective: Pelvic organ prolapse (POP) is common and has a high incidence of recurrence. Thus, there is a need for procedures that have higher rates of first-time success and attractive safety profiles. The aim of this study was to assess how well the Exair® (Coloplast, Humlebæk, Denmark) transvaginal mesh system corrected POP.
Materials and Methods: This was a prospective analysis of patients who received Exair transvaginal mesh between June 2013 and August 2015 for POP. Patients with uterine prolapse underwent vaginal mesh hysteropexy. A composite score that included subjective criteria of absence of a bothersome bulge, no prolapse below the hymen, and no retreatment was used to assess success.
Results: Transvaginal mesh was inserted in 80 patients (age 67 ± 9.2 years; body mass index 28.56 ± 5.18 kg/m2). Four patients (5%) received anterior mesh, 14 received (17.5%) posterior mesh, 61 (76.25%) received both anterior and posterior mesh—all via the Exair system—and 1 patient had a modified Exair surgery. Stage II prolapse was noted in 3 (3.75%) patients, 26 (32.5%) had stage III prolapse, and 51 (63.75%) had stage IV prolapse. The composite success score was 93% at a 1-year follow-up. Hysteropexy success was 93.5%. Mean operative time was 156.75 ± 47.35 minutes. Mean intraoperative blood loss was 181.89 ± 138.77 mL. There were 3 (4.2%) cases of mesh exposure in the vagina. There were no visceral injuries, and no cases of de novo dyspareunia, vaginal-wall retraction, voiding dysfunction, or de novo incontinence.
Conclusions: Exair mesh is a good option for managing POP.
Salil Khandwala.Journal of Gynecologic Surgery.Feb 2019.12-18.http://doi.org/10.1089/gyn.2018.0041 Published in Volume: 35 Issue 1: January 29, 2019 Online Ahead of Print:October 2, 2018