Long term subjective cure rate, urinary tract symptoms and dyspareunia following mesh augmented anterior vaginal wall prolapse repair. (December 2015)

• Record Type: Journal Article
• Authors: Weintraub, A.Y.; Friedman, T.; Baumfeld, Y.; Neuman, M.; Krissi, H.
• Is Part Of: International journal of surgery. Volume 24:Part A(2015)
• Page Start: 33
• Page End: 38
• Publication Date: 2015-12
• Subjects: Anterior vaginal prolapse -- Mesh augmentation -- Long term outcomes -- Adverse symptoms -- Recurrent prolapse surgery -- Overactive bladder; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2015.10.027
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Introduction: The aim of this study was to assess patient-centered long term outcomes following anterior vaginal repair with mesh. Methods: In January 2015, we identified 124 women who underwent anterior pelvic floor repair with mesh between January 2006 and February 2009. Patient records were reviewed and demographic, clinical, intra-operative and post-operative follow-up data retrieved. Telephone interviews were conducted to access information on clinical outcomes. Associations between baseline characteristics and long term symptoms were assessed by multivariable logistic regression models. Results: Seventy-nine women were reached and consented to participate. Patients were interviewed 79–104 months after surgery. Their mean age at the time of surgery was 62.48 ± 9.53 years; all had stage III cystocele with a mean POP Q point Ba of 5.32 ± 1.47. Twenty-four (30%) had a previous hysterectomy and 26 (33%) had a previous pelvic organ prolapse or stress urinary incontinence operation. At telephone interviews, recurrence of prolapse symptoms was reported by 11 (13.9%) patients, mostly in the posterior compartment. Only 6 needed a corrective procedure. One patient had her mesh removed due to dyspareunia. Eleven (13.9%) reported lower urinary tract symptoms other than prolapse, as follows: stress urinary incontinence (1), overactive bladder (8) and dyspareunia (2). Conclusion: Long term rates of recurrent prolapse, dyspareunia and lower urinary tract symptoms were low for patients who underwent anterior vaginal wall mesh augmentation surgery for symptomatic cystoceles. Highlights: We interviewed 79 women 79–104 months after anterior pelvic floor repair with mesh. 11 (13.9%) reported recurrence of prolapse, mostly in the posterior compartment. 6 needed a corrective procedure and one had her mesh removed due to dyspareunia. 11 (13.9%) reported lower urinary tract symptoms other than prolapse. Overall, long term patient centered outcomes were positive.