Synthetic Graft Augmentation in Vaginal Prolapse Surgery: Long-Term Objective and Subjective Outcomes.

Academic Article

Abstract

  • OBJECTIVE: To report long-term objectives and subjective outcomes in women who underwent prolapse surgery with a synthetic graft augmentation. DESIGN: Retrospective analysis (Canadian Task Force classification II-3). SETTING: University hospital in the southeastern United States. PATIENTS: Women with symptomatic pelvic organ prolapse who underwent transvaginal graft augmentation using the Prolift mesh system between July 2006 and December 2008 for a minimum 5-year follow-up. INTERVENTIONS: Subjects completed the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ), and the Patient Satisfaction Questionnaire. Subjects also underwent postoperative physical examination with Pelvic Organ Prolapse Quantification (POP-Q) and vaginal pain/stricture assessment. Long-term postoperative findings were compared with preoperative baseline data. MEASUREMENTS AND MAIN RESULTS: Of 208 eligible subjects, 70 completed the questionnaires only, and 48 of these 70 provided both postoperative examination and questionnaire data. The mean duration of follow-up was 7.0 ± 0.7 years (range, 5.8-8.1 years). POP-Q measurements of Ba (point B anterior), Bp (B posterior), C (cervix), GH (genital hiatus), PB (perineal body), and overall pelvic organ prolapse stage were significantly improved (all p < .001 except for PB, p = .006). PFIQ-7 (total, Urinary Impact Questionnaire, and Pelvic Organ Prolapse Impact Questionnaire) and PFDI-20 (total, Urinary Distress Inventory, and Pelvic Organ Prolapse Distress Inventory) scores significantly improved (all p < .001). No differences were noted in the colorectal-anal subscales (Colorectal-Anal Impact Questionnaire and Colorectal-Anal Distress Inventory) and PISQ scores at >5-year follow-up (all p > .05). Satisfaction rates were 15.7% for not at all, 35.7% for somewhat, and 48.6% for completely satisfied. Complications included graft exposure (n = 3; 6%) and dyspareunia (n = 25; 36%). CONCLUSION: Women undergoing transvaginal prolapse surgery using a synthetic graft continue to have positive objective and subjective outcomes, leading to significantly improved quality of life at a minimum 5-year follow-up.
  • Keywords

  • Long-term outcomes, Mesh, Pelvic organ prolapse, Prolapse surgery, Transvaginal mesh, Dyspareunia, Female, Follow-Up Studies, Humans, Middle Aged, Patient Satisfaction, Pelvic Floor, Pelvic Organ Prolapse, Postoperative Care, Quality of Life, Retrospective Studies, Southeastern United States, Surgical Mesh, Surveys and Questionnaires, Treatment Outcome, Urinary Incontinence, Uterine Prolapse, Vagina
  • Digital Object Identifier (doi)

    Author List

  • Meyer I; McGwin G; Swain TA; Alvarez MD; Ellington DR; Richter HE
  • Start Page

  • 614
  • End Page

  • 621
  • Volume

  • 23
  • Issue

  • 4