ABSTRACT

Pelvic organ prolapse (POP) significantly impairs the function of bladder, bowel and sexuality and reduces quality of life (QoL). The aim of POP surgery is the reconstruction of the pelvic organ anatomy and improvement of QoL. Conventional native tissue repair has a higher recurrence rate compared to the implantation of an alloplastic mesh. An increased risk of adverse events with first generation-meshes and no significant improvement of QoL is still a matter of debate. The purpose of this study was to investigate anatomical stability, complications, improvement of QoL, and the influence on POP-related symptoms after 36 months. 289 women with a symptomatic cystocele > grade I were treated with a titanium coated polypropylene mesh (TiLOOP® Total 6, pfm medical ag). POP-related QoL and symptoms were evaluated pre- and postoperatively. Mean age of patients was 67 ± 8 years. Preoperative POP-Q grades were diagnosed as following: 47.1% with grade II; 49.8% with grade III, and 3.1% with grade IV. Postoperatively, 21.8% of patients were cured (grade 0), 62.7% were diagnosed with grade I, 15.1% with grade II, and 0.4% with grade IV. The recurrence rate in the treated anterior compartment was very low (2.4% after twelve and 1.9% after 36 months, respectively). Concerning POP-related symptoms patients’ condition improved. Furthermore, QoL improved significantly in all nine investigated domains (p < 0.001, Wilcoxon test). Therefore, implantation of a second generation-mesh can be offered to patients with a recurrent or a high-grade prolapse after extensive patient information on the risks and benefits of mesh-supported POP repair.