Pelvic Organ Prolapse Repair with Mesh: Description of Surgical Technique Using the Surelift® Anterior Repair System.

Laura Mateu-Arrom, Cristina Gutiérrez-Ruiz, Joan Palou Redorta, Carlos Errando-Smet
Author Information
  1. Laura Mateu-Arrom: Female and Functional Urology Department, Fundació Puigvert, Barcelona, Spain, lmateuarrom@hotmail.com.
  2. Cristina Gutiérrez-Ruiz: Female and Functional Urology Department, Fundació Puigvert, Barcelona, Spain.
  3. Joan Palou Redorta: Urology Department, Fundació Puigvert, Barcelona, Spain.
  4. Carlos Errando-Smet: Female and Functional Urology Department, Fundació Puigvert, Barcelona, Spain.

Abstract

INTRODUCTION: Although the use of transvaginal mesh (TVM) in the repair of pelvic organ prolapse (POP) has been restricted, there are still some cases in which TVM may be the most appropriate approach. The TVM Surelift® anterior repair surgical technique has not been described previously.
OBJECTIVE: The aim of this study was to describe the surgical technique and to report our preliminary results regarding efficacy and complications.
METHODS: A step-by-step description of surgical technique is presented. A descriptive retrospective analysis was performed to evaluate our preliminary results in 17 women who underwent POP repair using the Surelift® anterior repair system in our department between 2014 and 2017. TVM was offered to patients with symptomatic apical (primary or recurrent) or recurrent anterior POP stage ≥2. POP recurrence was classified as asymptomatic anatomic or symptomatic. Patients rated satisfaction with surgery on a scale from 0 to 10. Complications during follow-up were classified according to the International Urogynecological Association/International Continence Society recommendations.
RESULTS: Median (IQR) follow-up was 19.9 months (24.8). Two (11.8%) anatomic recurrences were identified, both symptomatic, but neither required further surgery. No cases of pelvic pain, dyspareunia, voiding, or defecatory dysfunction were detected. Two (11.8%) patients presented a <1-cm vaginal mesh exposure (2AaT3S2) requiring partial mesh removal through a vaginal approach. At the end of follow-up, median satisfaction (IQR) with the surgery was 9 (3.1).
CONCLUSION: The Surelift® anterior repair system is effective in correcting apical or recurrent anterior POP, with a high patient satisfaction rate. Complications after this surgery are infrequent and are mostly related to vaginal mesh exposure.

Keywords

MeSH Term

Aged
Aged, 80 and over
Female
Humans
Middle Aged
Pelvic Organ Prolapse
Retrospective Studies
Surgical Mesh
Urologic Surgical Procedures

Word Cloud

Created with Highcharts 10.0.0repairmeshPOPanteriorTVMSurelift®surgerysurgicaltechniquesymptomaticrecurrentsatisfactionfollow-upvaginalPelvicpelvicorganprolapsecasesapproachpreliminaryresultspresentedsystempatientsapicalclassifiedanatomicComplicationsIQR9Two118%dysfunctionexposureRepairSurgicalINTRODUCTION:AlthoughusetransvaginalrestrictedstillmayappropriatedescribedpreviouslyOBJECTIVE:aimstudydescribereportregardingefficacycomplicationsMETHODS:step-by-stepdescriptiondescriptiveretrospectiveanalysisperformedevaluate17womenunderwentusingdepartment20142017offeredprimarystage≥2recurrenceasymptomaticPatientsratedscale010accordingInternationalUrogynecologicalAssociation/InternationalContinenceSocietyrecommendationsRESULTS:Median19months248recurrencesidentifiedneitherrequiredpaindyspareuniavoidingdefecatorydetected<1-cm2AaT3S2requiringpartialremovalendmedian31CONCLUSION:effectivecorrectinghighpatientrateinfrequentmostlyrelatedOrganProlapseMesh:DescriptionTechniqueUsingAnteriorSystemFemalefloorTransvaginalUrogynecology

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