Details

Autor(en) / Beteiligte

• Jacquetin, B.
• Hinoul, P.
• Gauld, J.
• Fatton, B.
• Rosenthal, C.
• Clavé, H.
• Garbin, O.
• Berrocal, J.
• Villet, R.
• Salet-Lizée, D.
• Debodinance, P.
• Cosson, M.

Titel

Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 5-year prospective follow-up study

Ist Teil von

• International Urogynecology Journal, 2013-10, Vol.24 (10), p.1679-1686

Ort / Verlag

London: Springer London

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Introduction and hypothesis To evaluate clinical effectiveness and complication rates at 5 years following the total Trans Vaginal Mesh (TVM) technique to treat pelvic organ prolapse. Methods Prospective, observational, multi-centre study in patients with prolapse of stage II or higher. Results Of the 90 women enrolled in the study, 82 (91 %) were available for the 5-year follow-up period. At the 5-year endpoint, success, defined as no surgical prolapse reintervention and leading edge <−1 (International Continence Society [ICS] criteria) or above the level of the hymen, was 79 % and 87 % respectively. A composite criterion of success defined as: leading edge above the hymen (<0) and no bulge symptoms and no reintervention for prolapse was met by 90 %, 88 % and 84 % at the 1-, 3-, and 5-year endpoints respectively. Quality of life improvement was sustained over the 5 years. Over the 5-year follow-up period, a total of only 4 patients (5 %) required re-intervention for prolapse, while a total of 14 patients (16 %) experienced mesh exposure for which 8 resections needed to be performed. Seven exposures were still ongoing at the 5-year endpoint, all asymptomatic. Only 33 out of 61 (54 %) sexually active patients at baseline remained so at 5 years. De novo dyspareunia was reported by 10 %, but no new cases at the 5-year endpoint. One patient reported de novo unprovoked mild pelvic pain at 5 years, 5 reported pains during pelvic examination only. Conclusions Five-year results indicated that TVM provided a stable anatomical repair. Improvements in QOL and associated improvements in prolapse-specific symptoms were sustained. Minimal new morbidity emerged between the 1- and 5-year follow-up.