ABSTRACT

Introduction:

Pelvic organ prolapse (POP) repair with synthetic mesh has low recurrence and good anatomical correction. The newgeneration meshes may provide better outcomes than meshes with greater superficial density. This multicenter study aimed to evaluate the outcomes of POP repair using Calistar S (CaS; 44 g/cm²) versus Calistar A (CaA; 16 g/cm²).

Methods:

Data from women with anterior and/or apical POP repaired with either CaA (n=91) or CaS (n=126) between January 1, 2011 and April 30, 2017 were retrospectively analyzed. The primary endpoint was the overall response based on Barber’s criteria. Secondary endpoints were anatomical correction and patient-reported outcomes assessed with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Pelvic Floor Disability Index (PFDI-20). Adverse events were recorded. Minimum follow-up was 6 months.

Results:

Barber’s criteria for cure were met by 75 (82%) in the CaA group and 114 (90%) in the CaS group (p=0.0806). Anatomical correction was significantly improved in both groups from a median POP-Q stage of 3 preoperatively to 1 postoperatively (p<0.0001 in both groups). Quality of life (measured by the PISQ-12 or PDFI-20) showed similar significant improvements from baseline in both groups. De novo overactive bladder only occurred in the CaA group (p=0.0121), and urinary tract infection, mesh exposure, and de novo stress urinary incontinence were significantly more frequent in the CaA group than the CaS group. Rare adverse events (only one case per event) occurred in the CaA group.

Conclusion:

Ultra-light-weight CaS is safer and achieves a similar success rate compared with heavier-weight CaA.