Modified surelift anterior-apical transvaginal mesh for advanced urogenital prolapse: Retrospective surgical, functional and sonographic outcomes at 3 years.

Tsia-Shu Lo, Fazlin Harun, Lan-Sin Jhang, Wu-Chiao Hsieh, Yiap Loong Tan, Aisha Alzabedi
Author Information
  1. Tsia-Shu Lo: Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Medical Center, Taipei, Taiwan; Chang Gung University, School of Medicine, Taoyuan, Taiwan. Electronic address: 2378@cgmh.org.tw.
  2. Fazlin Harun: Department of Obstetrics and Gynecology, Women and Children Hospital (Hospital Tunku Azizah), Kuala Lumpur, Malaysia.
  3. Lan-Sin Jhang: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Tucheng, Medical Center, Taipei, Taiwan.
  4. Wu-Chiao Hsieh: Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University, School of Medicine, Taoyuan, Taiwan.
  5. Yiap Loong Tan: Department of Obstetrics and Gynecology, Kuching Specialist Hospital, KPJ Healthcare Group, Sarawak, Malaysia.
  6. Aisha Alzabedi: Women Health Center, International Medical Center (IMC) Hospital, Jeddah, Saudi Arabia.

Abstract

OBJECTIVE: This study evaluates the outcomes of modified transvaginal mesh (TVM) Surelift in managing advanced pelvic organ prolapse (POP) over a 3-year follow-up period, focusing on surgical success, functional improvement, and sonographic findings.
METHODS: A retrospective review was conducted on 99 women who underwent Surelift System surgery for advanced POP Stage III and IV between July 2018 to January 2020. Objective evaluation included Pelvic Organ Prolapse Quantification (POP-Q), multichannel urodynamic (UDS), and introital 2D ultrasonographic measurement. Subjective evaluation uses validated questionnaires of Incontinence Impact Questionnaire-7(IIQ-7), Urogenital Distress Inventory-6(UDI-6), Pelvic Organ Prolapse Distress Inventory 6(POPDI-6), Colorectal Anal Distress Inventory-8(CRADI-8) and Pelvic organ prolapse/ Urinary Incontinence Sexual Questionnaire (PISQ-12). Outcomes were examined at 3 months, yearly and at 3 years postoperative. Secondary outcome included de novo or persistent urodynamic stress incontinence (USI) and surgical complications.
RESULTS: Eighty-five women were included in the final analysis. At 3 years postoperative, the objective cure rate was 94.1 % and subjective cure rate of 91.8 %. Ultrasonography revealed initial mesh elongation and thickening at first year, resolving by the third year, while the distance between the bladder neck and mesh remained stable. Significant improvement in POP-Q components (Aa,Ba,C,Ap,Bp and TVL of p < 0.001), UDS (p < 0.001) and all validated Quality of Life (QoL) questionnaires (p < 0.001) were seen. De Novo USI and persistent USI occurred in 31.5 %. Complications included vaginal mesh exposure requiring excision in 4.7 % of patients, and one intraoperative bladder injury corrected promptly.
CONCLUSION: The Surelift System TVM demonstrates safety and efficacy in treating advanced anterior-apical POP, achieving high cure rates, secured mesh placement, and minimal complications at 3 years post-operative.

Keywords

MeSH Term

Humans
Female
Retrospective Studies
Pelvic Organ Prolapse
Middle Aged
Aged
Surgical Mesh
Ultrasonography
Treatment Outcome
Suburethral Slings
Urinary Incontinence, Stress
Quality of Life
Vagina

Word Cloud

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