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Fayyad A, Harris R, Ibrahim S. Two-year anatomical and functional outcomes of laparoscopic sacrocolpopexy using light-weight Y shaped mesh for post hysterectomy vaginal prolapse. Eur J Obstet Gynecol Reprod Biol 2022; 270:139-143. [DOI: 10.1016/j.ejogrb.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 11/16/2022]
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Tailor V, Digesu A, Swift SE. Update in Transvaginal Grafts: The Role of Lightweight Meshes, Biologics, and Hybrid Grafts in Pelvic Organ Prolapse Surgery. Obstet Gynecol Clin North Am 2021; 48:515-533. [PMID: 34416935 DOI: 10.1016/j.ogc.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Transvaginal mesh/grafts have been popularized over the past 20 years in an attempt to improve the longevity of traditional vaginal pelvic organ prolapse (POP) surgery. Several national bodies have concluded that the proposed benefits of mesh/graft implantation are outweighed by the significant increase in surgery complications related to these products. As a consequence mesh products for vaginal POP surgery have been withdrawn from use in many countries. This article is a narrative review of newer mesh and graft products including lightweight polypropylene mesh products, biological grafts, hybrid grafts, and tissue engineered grafts.
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Affiliation(s)
- Visha Tailor
- Department of Urogynaecology, St Marys Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, United Kingdom.
| | - Alex Digesu
- Department of Urogynaecology, St Marys Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, United Kingdom
| | - Steven Edward Swift
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA
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Anterior/Apical single incision mesh (Elevate™): Surgical experience, anatomical and functional results, and long-term complications. Eur J Obstet Gynecol Reprod Biol 2021; 260:166-170. [PMID: 33813235 DOI: 10.1016/j.ejogrb.2021.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/22/2021] [Accepted: 03/19/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Pelvic organ prolapse is a common condition among post-menopausal women, and surgery is often the standard treatment proposed. Native tissue vaginal surgery is burdened by a high rate of recurrence, and mesh vaginal surgery has become current practice. The purpose of this study was to evaluate the safety and the effectiveness of the vaginal kit Anterior/Apical single incision mesh Elevate™ for the correction of anterior and apical compartment prolapse. STUDY DESIGN Data of patients with symptomatic anterior vaginal prolapse stage ≥ II, receiving mesh repair with the Anterior/Apical Elevate single incision system between January 2010 and January 2015 were retrieved. Prolapse was classified according to the POP-Q system. The main outcome measure was anatomical success, while subjective and safety outcomes were secondary outcomes. RESULTS Anatomical success rate was 87.2 % for anterior compartment prolapse and 84.6 % for combined anterior and apical prolapse, while overall functional success rate was 96.2 % after a median follow-up of 33.6 months. The most frequent short-term complications were urinary bladder injury (3.0 %) and transient urinary retention (6.9 %). The most common long-term complications were de novo or persistent symptomatic stress urinary incontinence (10.8 %) and vaginal mesh extrusion (3.8 %). CONCLUSION Mesh vaginal surgery with Anterior/Apical single incision mesh Elevate™ is a well-tolerated procedure with a very high anatomical and functional success rate. Short and long-term complications rate seem to be acceptable, and in most of cases, solvable. Further studies are needed to confirm our promising data.
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Lin KL, Tang FH, Chou SH, Loo ZX, Liu YY, Juan YS, Long CY. Evaluation of single-incision apical vaginal suspension for treatment of pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 2020; 247:198-202. [PMID: 32146224 DOI: 10.1016/j.ejogrb.2020.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/01/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To present a comprehensive evaluation of anterior/apical and/or posterior prolapse repair systems with a focus on safety and surgical efficacy. METHODS Two hundred and twenty women with pelvic organ prolapse (POP) stage II-IV were referred for single-incision transvaginal mesh procedures in a single institution. Pre- and postoperative assessments included pelvic examination, urodynamic studies, and personal interviews about patients' quality of life and urinary symptoms. RESULTS The anatomical success rate was 92.3 % (203/220), regardless of primary or de-novo POP, at 12-38 month follow-up. The POP quantification parameters, except total vaginal length, improved significantly after surgery (p < 0.05). Complications included bladder injury (one case), mesh exposure (six cases) and urinary retention that required intermittent catheterization (five cases). There were no cases of bowel injury during surgery. The results indicated that 29 % of patients had de-novo stress urinary incontinence and 7.7 % of patients had de-novo POP after surgery. CONCLUSION The apical vaginal suspension system is a safe and effective procedure, creating good anatomical restoration and significant improvement in quality of life. However, the rate of de-novo POP in the anterior compartment of the vagina (31.8 %) seems high after treatment with apical and posterior prolapse repair systems.
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Affiliation(s)
- Kun-Ling Lin
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Feng-Hsiang Tang
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Hsiang Chou
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Zi-Xi Loo
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Yin Liu
- Department of Obstetrics and Gynaecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Shun Juan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Yu Long
- Department of Obstetrics and Gynaecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Li YL, Chang YW, Yang TH, Wu LY, Chuang FC, Kung FT, Huang KH. Mesh-related complications in single-incision transvaginal mesh (TVM) and laparoscopic abdominal sacrocolpopexy (LASC). Taiwan J Obstet Gynecol 2020; 59:43-50. [DOI: 10.1016/j.tjog.2019.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2019] [Indexed: 11/29/2022] Open
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Efficacy and safety of the Calistar and Elevate anterior vaginal mesh procedures. Eur J Obstet Gynecol Reprod Biol 2019; 239:30-34. [PMID: 31163354 DOI: 10.1016/j.ejogrb.2019.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/05/2019] [Accepted: 05/24/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The pelvic organ prolapse (POP) surgery with implantation of anterior transvaginal mesh (e.g. Elevate or Calistar) may provide objective and subjective improvement as compared to traditional POP repair without mesh. Given differences between the Elevate and the Calistar mesh and their different placement methods, some variation inlong-term clinical outcomes of these anterior vaginal mesh procedures can be expected. STUDY DESIGN The purpose of the study was to compare the 18-month operative success in patients who had undergone anterior POP surgery with either the Calistar (n = 54) or Elevate mesh (n = 50). RESULTS There were no between-group differences in objective measures of operative efficacy, including POP-Q anterior stage 0 or I (94% for Calistar, 92% for Elevate) and "no descent beyond the hymen" (98% for Calistar, 94% for Elevate). The proportion of patients with subjective measure of operative efficacy (no vaginal bulge symptoms) did not differ between the groups (91% for Calistar, 78% for Elevate). There were no between-group differences in the proportion of women suffering from vaginal exposure, de novo stress urinary incontinence (SUI), de novo overactive bladder (OAB) symptoms, pelvic floor pain or dyspareunia. The operative cure of OAB symptoms was similar in the groups. The proportion of patients with the operative cure of SUI symptoms was significantly higher in the Calistar as compared to the Elevate group. CONCLUSIONS The results suggestthat the Calistar system offers similar efficacy in the treatment of anterior and both anterior and apical POP as compared to the Elevate. The use of anterior Calistar is associated with some additional benefits, i.e. SUI treatment in patients with concomitant anterior and both anterior and apical POP and SUI symptoms.
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González Palanca SJ, González Veiga EJ, Palmeiro Fernández G, Domínguez Salgado JC, Mariño Méndez H, Varela Ponte C. Long-term results of genital prolapse surgery with polypropylene mesh. Actas Urol Esp 2019; 43:254-261. [PMID: 30955903 DOI: 10.1016/j.acuro.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/20/2018] [Accepted: 12/02/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVE The risk of intervention due to urogenital prolapse in a woman's life is 11.1%. Recurrences after classic surgery reach up to 38%. With the aim of improving these results, transvaginal mesh kits are used. The purpose of the study is to describe the results of efficacy and long-term safety of vaginal prolapse surgery with polypropylene mesh, assess subjective symptoms before and after surgery and the level of satisfaction. PATIENTS AND METHODS A descriptive, retrospective study of 58 women with symptomatic genital prolapses operated with polypropylene mesh between September / 2011-November / 2016. Mean age: 66.53 years, 98.27% menopausal women, 77.59% overweight/obesity, 29.31% with previous gynaecological surgery and 55.17% with combined prolapse. 46 Elevate anterior and 12 posterior were inserted. The mean follow-up period was 34.02 months. The PFDI questionnaire was used pre and post-surgery, as well as the satisfaction questionnaire. RESULTS Healing rate of 91.38%. Recurrences were associated with a higher BMI and with background of recurrence of previous surgery. Mean length of stay: 2.5 days. 70.69% did not need analgesia at discharge. Clavien-Dindo complications: 1 type I (urinary retention), 5 type II (urinary tract infection) and 1 type IIIa (erosion). De novo stress urinary incontinence occurred in 3.44%, while de novo dyspareunia 14.28%. 89.36% patients improved subjective symptoms, and 95.92% were satisfied. CONCLUSION This surgery achieves high healing rates, with few complications, improvement of subjective symptoms and high level of satisfaction of the patients.
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Affiliation(s)
- S J González Palanca
- Servicio de Ginecología y Obstetricia, Hospital Comarcal Valdeorras, O Barco, Ourense, España.
| | - E J González Veiga
- Servicio de Ginecología y Obstetricia, Hospital Comarcal Valdeorras, O Barco, Ourense, España
| | - G Palmeiro Fernández
- Servicio de Ginecología y Obstetricia, Hospital Comarcal Valdeorras, O Barco, Ourense, España
| | - J C Domínguez Salgado
- Servicio de Ginecología y Obstetricia, Hospital Comarcal Valdeorras, O Barco, Ourense, España
| | - H Mariño Méndez
- Servicio de Ginecología y Obstetricia, Hospital Comarcal Valdeorras, O Barco, Ourense, España
| | - C Varela Ponte
- Servicio de Ginecología y Obstetricia, Hospital Comarcal Valdeorras, O Barco, Ourense, España
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Chang YW, Chuang FC, Wu LY, Yang TH, Kung FT, Huang KH. Evaluating the efficacy of the single-incision uphold system for pelvic organ prolapse repair. Taiwan J Obstet Gynecol 2019; 58:94-98. [DOI: 10.1016/j.tjog.2018.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 11/28/2022] Open
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Long-term follow-up of patients treated by transvaginal mesh repair for anterior prolapse. Eur J Obstet Gynecol Reprod Biol 2018; 230:124-129. [PMID: 30269022 DOI: 10.1016/j.ejogrb.2018.09.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/17/2018] [Accepted: 09/11/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of the study was to assess 5 years outcome of transvaginal single incision mesh surgery (SIMS) for anterior pelvic organ prolapse (POP). STUDY DESIGN This was a prospective study including all patients from January 2009 to December 2012 who underwent SIMS for symptomatic anterior prolapse stage ≥2, according to POP Quantification (POP-Q). Symptoms and quality of life were assessed using validated questionnaires: Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact questionnaire (PFIQ-7), and Prolapse/ Incontinence Sexual Questionnaire (PISQ-12). Main outcome was subjective success (question 3 of PFDI-20 score = 0). Mesh-related complications, objective and functional outcomes were used as the secondary outcomes. RESULTS 270 patients were included in the study. Median follow-up was 5,7 years [4,5-8,2]. Subjective success rate was 86,6% at 5 years. Objective success rate was 53,1% at 5 years. At 5 years, composite failure (subjective + objective) occurred for 17 patients (12%), 7 patients with direct recurrence and 10 with indirect recurrence. Re-treatment was performed in six patients (2,8%; 3 hysterectomies for apical recurrence and 3 posterior repairs for posterior recurrence). One case (0,4%) of asymptomatic mesh exposure occurred. The reoperation rate for mesh-related complications was 3,4%. At 5 years, de novo dyspareunia rate was 11,7%, 3,9% considered as mesh-related. A significant improvement was noted for symptoms and quality of life. CONCLUSION Five-year results demonstrate that vaginal mesh surgery provides a durable and safe repair of anterior compartment prolapse with a low rate of mesh-related complications and reoperations. Between the 2- and 5-year follow-up, patient satisfaction and associated improvements in prolapse-specific symptoms were sustained and minimal new morbidity occurred.
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Buca DIP, Liberati M, Falò E, Leombroni M, Di Giminiani M, Di Nicola M, Santarelli A, Frondaroli F, Fanfani F. Long-term outcome after surgical repair of pelvic organ prolapse with Elevate Prolapse Repair System. J OBSTET GYNAECOL 2018. [PMID: 29537324 DOI: 10.1080/01443615.2017.1419462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Female pelvic organ prolapse (POP) is a common condition and the correction of prolapse remains a major challenge for the surgical community. A retrospective study of women with POP undergoing pelvic reconstructive surgery with the Elevate System followed-up for 48 months. A total of 138 women with POP were included in the study. We observed an objective cure rate of 94.9% for the anterior wall after 4 years' follow-up. The subjective cure rate was 97.1%. Improvement in the urinary symptoms was seen after the surgery: the number of asymptomatic patients increased from 14.5 to 77% after the 4 years of follow-up. We reported no cases of bleeding, haematoma, mesh infection and bowel injury, while we had four cases of bladder injury and one case of sepsis. The mesh extrusion rate was 7.3%, all cases interested the anterior compartment. Postoperative dyspareunia and pelvic pain were rare. In this cohort, the Elevate Prolapse Repair System was associated with excellent long-term results, for both anatomical corrections of prolapse, with a high objective and subjective cure rate and a functional urinary outcome. Impact statement What is already known on this subject? Female pelvic organ prolapse is a common condition and the correction of prolapse remains a major challenge for the surgical community. The optimal treatment of POP has still to be determined. What do the results of this study add? The findings from this study shows that the Elevate Prolapse Repair System had high anatomic results associated with a good durability, low morbidity and excellent subjective outcome. To the best of our knowledge, this is the first study that reports a follow-up up to 48 months. What are the implications of these findings for clinical practice and/or further research? The Elevate Prolapse Repair System was associated with excellent long terms results in terms of safety, durability and tolerability during the 4 years' follow-up. Despite the fact that the Elevate kit produced by AMS was withdrawn from the market and it is no longer available, we believe that it is helpful to have data about the outcomes of a transvaginal mesh implant.
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Affiliation(s)
- Danilo Italo Pio Buca
- a Department of Obstetrics and Gynaecology , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
| | - Marco Liberati
- a Department of Obstetrics and Gynaecology , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
| | - Eleonora Falò
- a Department of Obstetrics and Gynaecology , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
| | - Martina Leombroni
- a Department of Obstetrics and Gynaecology , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
| | - Maria Di Giminiani
- b School of Medicine and Health Science , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
| | - Marta Di Nicola
- c Laboratory of Biostatistics Department of Medical , Oral and Biotechnological Sciences G. d'Annunzio University , Chieti , Italy
| | - Alessandro Santarelli
- a Department of Obstetrics and Gynaecology , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
| | - Franco Frondaroli
- a Department of Obstetrics and Gynaecology , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
| | - Francesco Fanfani
- d Department of Medicine and Ageing Sciences , G. d'Annunzio University of Chieti-Pescara , Chieti , Italy
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Castellani D, Galica V, Saldutto P, Galatioto GP, Vicentini C. Efficacy and safety of Elevate® system on apical and anterior compartment prolapse repair with personal technique modification. Int Braz J Urol 2017; 43:1115-1121. [PMID: 28266815 PMCID: PMC5734075 DOI: 10.1590/s1677-5538.ibju.2016.0233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 09/11/2016] [Indexed: 11/22/2022] Open
Abstract
AIM To evaluate the effectiveness and safety of Anterior Elevate® mesh kit system (AES) in woman with symptomatic stage 3 or 4 anterior and/or apical pelvic organ prolapse (POP). MATERIALS AND METHODS This retrospective, monocentric, single surgeon study enrolled between May 2010 and January 2013 fifty-six woman experiencing symptomatic anterior vaginal prolapse with or without apical descent (POP-Q stage 3 or 4). All women received a AES and 7 (12.5%) received a concomitant transvaginal hysterectomy. Primary endpoint was anatomic correction of prolapse; success was defined as POP-Q stage ≤ 1 or asymptomatic stage 2. Secondary endpoints were quality-of-life (QOL) results and patients' safety outcomes, which were assessed by 3 validated self-reporting questionnaires at baseline and annually: ICIQ-UI short form, ICIQ-VS and P-QOL. All patients completed 2-years and 28 women 3-years of follow-up. Surgical approach was modified in women with uterus, moving the two-propylene strips anteriorly around the cervix itself crossing one another, so the left will take place in the right side and the right on the opposite. This modification was made in order to better support the uterus. RESULTS Vaginal mesh exposure was present in 3 (5,3%) patients. Very good anatomical outcomes were seen, with one (1,8%) failure at 6-months, 4 (7,1%) at 1-year, 6 at 2-years (10,7%). Statistically significant improvements were seen in the ICIQ-VS and P-QOL questionnaires throughout follow-up. CONCLUSION Our data suggest that AES is a minimally-invasive transvaginal procedure to repair anterior and apical POP, with good evidence related to mid-term safety and efficacy.
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Affiliation(s)
- Daniele Castellani
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Urology Unit, “Giuseppe Mazzini” Hospital, Teramo, Italy
| | - Vikiela Galica
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Urology Unit, “Giuseppe Mazzini” Hospital, Teramo, Italy
| | - Pietro Saldutto
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Urology Unit, “Giuseppe Mazzini” Hospital, Teramo, Italy
| | - Giuseppe Paradiso Galatioto
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Urology Unit, “Giuseppe Mazzini” Hospital, Teramo, Italy
| | - Carlo Vicentini
- Department of Life, Health & Environmental Sciences, University of L'Aquila, Urology Unit, “Giuseppe Mazzini” Hospital, Teramo, Italy
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Barros-Pereira I, Valentim-Lourenço A, Fonseca A, Melo B, Henriques A, Ribeirinho A. A retrospective analysis of the effectiveness of anterior pelvic organ prolapse repair with Prolift versus Elevate vaginal mesh. Int J Gynaecol Obstet 2017; 139:192-196. [PMID: 28718906 DOI: 10.1002/ijgo.12267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/28/2017] [Accepted: 07/14/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To compare the effectiveness of anterior pelvic organ prolapse (POP) repair using Prolift (Ethicon, Somerville, NJ, USA) or Elevate (American Medical Systems, Minnetonka, MN, USA) vaginal mesh at 12 months of follow-up. METHODS A retrospective study was undertaken using the records for the first 50 Prolift procedures in 2007-2009 and the first 50 Elevate procedures in 2013-2015 performed at a tertiary urogynecology unit in Lisbon, Portugal. Postoperative follow-up occurred at 3, 6, and 12 months. The primary outcome was surgical efficacy using subjective and objective measures (vaginal bulge symptoms and POP quantification system according to the Weber criteria, respectively) at 12 months. RESULTS Improvement according to the Weber criteria was noted for 10 (25%) of 40 women in the Prolift group and 21 (48%) of 44 in the Elevate group at 12 months (P=0.032). Additionally, the Ba point was higher with Elevate than with Prolift (-2.2 ± 1.1 vs -1.5 ± 1.5; P=0.031). Vaginal bulge symptoms were reported at 12 months by 7 (18%) women in the Prolift group and 3 (7%) in the Elevate group (P=0.021). CONCLUSION Differences in anatomic results were apparent between the two vaginal mesh groups 12 months after surgery.
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Affiliation(s)
- Isabel Barros-Pereira
- Clínica Universitária de Obstetrícia e Ginecologia, Centro Hospitalar Lisboa Norte - Hospital Universitário de Santa Maria, Lisbon, Portugal
| | - Alexandre Valentim-Lourenço
- Clínica Universitária de Obstetrícia e Ginecologia, Centro Hospitalar Lisboa Norte - Hospital Universitário de Santa Maria, Lisbon, Portugal
| | - Andreia Fonseca
- Clínica Universitária de Obstetrícia e Ginecologia, Centro Hospitalar Lisboa Norte - Hospital Universitário de Santa Maria, Lisbon, Portugal
| | - Bruna Melo
- Hospital do Divino Espirito Santo, Ponta Delgada, Autonomous Region of the Azores, Portugal
| | - Alexandra Henriques
- Clínica Universitária de Obstetrícia e Ginecologia, Centro Hospitalar Lisboa Norte - Hospital Universitário de Santa Maria, Lisbon, Portugal
| | - Ana Ribeirinho
- Clínica Universitária de Obstetrícia e Ginecologia, Centro Hospitalar Lisboa Norte - Hospital Universitário de Santa Maria, Lisbon, Portugal
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To V, Hengrasmee P, Lam A, Luscombe G, Lawless A, Lam J. Evidence to justify retention of transvaginal mesh: comparison between laparoscopic sacral colpopexy and transvaginal Elevate™ mesh. Int Urogynecol J 2017. [DOI: 10.1007/s00192-017-3379-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Poizac S, Ferry P, Cayrac M, Quiboeuf E, Marcelli M, Tourette C, Agostini A. [Feasability and morbidity of apical and anterior mesh repair, a multicenter cohort study]. Prog Urol 2017; 27:497-505. [PMID: 28549730 DOI: 10.1016/j.purol.2017.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 04/20/2017] [Accepted: 05/05/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess safety anatomic results, satisfaction patient and to report short-term results of a new surgical approach for a combined treatment of pelvic organ prolapse (POP) of anterior and medium compartments. MATERIAL AND METHODS A longitudinal case series of 83 consecutive patients operated between January 2012 and April 2014 in four tertiary centers by 8 surgeons. Potential complications have been reported. The satisfaction of patients was conducted at 6 weeks post-procedure. The anatomical evaluation was conducted at 6 weeks and 6 months post-procedure. Anatomic success was defined as prolapse stage<1 (POPQ) for both anterior and apical compartment. RESULTS Mean age was 69.2±8.6 years. There were two intraoperative complications: a bladder injury and an ureteral injury. Postoperative complications were 14/83 (16.8%) transient urinary retentions. Seventy-three patients out of 83 (87.9%) were available for anatomic evaluation at 6 months. Anatomical success at 6 months for both anterior and apical compartments was 68/73 (93.1%). Patient satisfaction rate at 6 months was 79/83 (95.1%). Four subjects/73 (5.5%) experienced mesh exposure treated conservatively. CONCLUSION In the current series, uterovaginal suspension anterior using a mesh Nuvia® was associated with correct anatomical results and a good satisfaction of patients. This technique seems reproducible and associated with few complications. Prospective, comparative and long-term data are required to confirm these results. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- S Poizac
- Service de gynécologie-obstétrique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - P Ferry
- Service de gynécologie-obstétrique, centre hospitalier La-Rochelle, rue du Docteur-Schweitzer, 17000 La Rochelle, France
| | - M Cayrac
- Service de gynécologie-obstétrique, hôpital Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34100 Montpellier, France
| | - E Quiboeuf
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, université de Bordeaux 2, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France
| | - M Marcelli
- Service de gynécologie-obstétrique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France
| | - C Tourette
- Service de gynécologie-obstétrique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France
| | - A Agostini
- Service de gynécologie-obstétrique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France
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Yang TH, Wu LY, Chuang FC, Kung FT, Huang KH. Comparing the midterm outcome of single incision vaginal mesh and transobturator vaginal mesh in treating severe pelvic organ prolapse. Taiwan J Obstet Gynecol 2017; 56:81-86. [DOI: 10.1016/j.tjog.2016.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/29/2022] Open
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Cour F, Le Normand L, Meurette G. Traitement par voie basse des colpocèles postérieures : recommandations pour la pratique clinique. Prog Urol 2016; 26 Suppl 1:S47-60. [DOI: 10.1016/s1166-7087(16)30428-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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