ABSTRACT

Urogynecologists are constantly looking for simple, safe and durable methods to cure pelvic organ prolapse (POP). We used a novel surgical technique utilizing synthetic mesh (Prolift®, Gynecare, Summerville, NJ, USA) to reinforce the pelvic floor in cases of POP with high risk of recurrence, while preserving the uterus. The aim of this study was to analyze cure rates as well as peri-operative data and peri-operative complications. Patients with advanced POP and being at risk for recurrence were enrolled into the study and underwent Proift mesh implantation, hysterectomy was performed for indications other then prolapse or upon patient’s request. Previous POP surgical reconstruction, first degree relative with significant pelvic floor fascial defect and poor pelvic supportive tissue were regarded as risk factors for POP recurrence. Pre-operative demographic data, operative details and immediate postoperative fohow-up data were prospectively collected for ali patients. A total of 459 POP patients were subjected to the mesh operation in an ovemight setting. Two hundred and thirty patients (50%) were operated for prolapse of the anterior compartment, 229 (50%) for prolapse of the posterior compartment and 302 (66%) for both, with 85 (18%) of them undergoing implantation of both anterior and posterior pelvic floor meshes; the others had a single pelvic floor compartment mesh implantation with opposite side colporrhaphy. Uteri were preserved with 291 (95%) patients suffering uterine prolapse. Peri-operative complications inclu-ded bladder penetration (1%) and rectal laceration (0.2%). Early and late adverse outcome were hematoma (1%), vaginal mesh exposure (2%) and recurrence (4%). Total un-favorable outcome was 7%. Ali these women were cured with no morbid sequela. The mesh POP reconstruction operation carries a low comphcation rate. Uterine preservation is feasible and safe. The current study supports the previously reported favorable therapeutic outcome of this procedure.