Retrospective study of transobturator polypropylene mesh kit for the management of pelvic organ prolapse.
- Author:
Ganesh Raj VAIYAPURI
1
;
How Chuan HAN
;
Lih Charn LEE
;
Arthur Leng Aun TSENG
;
Heng Fok WONG
Author Information
- Publication Type:Journal Article
- MeSH: Female; Humans; Intraoperative Complications; epidemiology; etiology; Middle Aged; Pelvic Organ Prolapse; surgery; Postoperative Complications; epidemiology; etiology; Recurrence; Retrospective Studies; Suburethral Slings; Surgical Mesh; adverse effects; Time Factors; Treatment Outcome; Uterine Prolapse; surgery
- From:Singapore medical journal 2012;53(10):664-670
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONThis retrospective study assessed the surgical outcomes of patients for whom the transobturator polypropylene mesh kit was used for the management of pelvic organ prolapse (Gynecare Prolift) in a tertiary urogynaecological centre in Singapore from January 1, 2006 to December 31, 2007.
METHODS169 patients (2006 n = 95; 2007 n = 74) with total (n = 76), anterior (n = 82) and posterior (n = 11) Prolifts were followed up for two years post-surgery.
RESULTSIntraoperatively, the incidence of haematoma, blood loss > 1,000 mL and blood transfusion was lower in 2007 than in 2006, although the difference was not statistically significant. One (1.4%) patient had rectal perforation in 2007. The mesh erosion rates were similar for all Prolift types (total 17.2%; posterior 14.5%; anterior 18.2%). Two patients, who had total Prolift in 2006, required mesh excision under anaesthesia for mesh extrusion. 138 (81.7%) patients were available for review at two years - nine (6.5%) patients had recurrent cystourethrocoeles and two (1.4%) had recurrent vault prolapse. Of the nine patients who had total Prolift with uterine conservation, two (1.4%) had recurrent uterine descent. The subjective cure rates two years after Prolift surgery were 98.7% for patients from 2006 and 100% for patients from 2007. The objective cure rates were 89.6% for patients from 2006 and 91.8% for patients from 2007.
CONCLUSIONProlift mesh surgery appears to have a very high success rate for pelvic reconstructive surgery. The learning curve of the surgeon may, however, be a factor determining surgical outcome in these patients.