Long-term (8.5 years) analysis of the type and rate of reoperation after transvaginal mesh repair (Prolift®) in 349 patients. (January 2019)

• Record Type: Journal Article
• Authors: Pécheux, Océane; Giraudet, Géraldine; Drumez, Elodie; Di Serio, Marcello; Estelle, Jean-dit-Gautier; De Landsheere, Laurent; Cosson, Michel
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 232(2019)
• Page Start: 33
• Page End: 39
• Publication Date: 2019-01
• Subjects: Exposure -- Mesh -- POP (pelvic organ prolapse) -- Prolift -- Recurrence; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2018.10.009
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Objective: Polypropylene meshes have specific complications, and in 2016 the Food and Drug Administration required a Premarket Approval for their use in pelvic prolapse repair, as there was a lack of long-term data. Our objectives were to determine the long-term reoperation rates and type in our patients after transvaginal mesh repair and to study their risk factors. Study design: We were able to follow up with 349 patients from a single University Hospital, with phone calls, after a median time of 8, 5 years. The 8.5-year reoperation rates were derived from Kaplan-Meier survival curves. Results: Our global, long-term reoperation rate, including mesh complications, prolapse recurrence and urinary incontinence after a median follow-up of 8.5 years, was 14.5%. The mesh-related complication rate (including mesh exposures, infections, and retractions requiring surgery) was 4.3%, the urinary incontinence rate was 5.7%. The prolapse recurrence rate was 7.2%; mainly found with posterior mesh only (18.5% of reoperations). For total Prolift, the reoperation rate for prolapse recurrence was only 4%. Moreover, 867% of the patients who had an anterior Prolift only or a posterior Prolift only and who were re-operated for prolapse recurrence showed recurrence exclusively in another compartment. In bivariate analysis, only the posterior mesh type was significantly associated with prolapse recurrence versus total meshes. Conclusion: Despite their market withdrawal, the transvaginal meshes are a safe and efficient option for pelvic organ prolapse surgical management. Low rates of mesh complications can be achieved with cautious dissection and adequate training of surgeons.