Mid-term results of pelvic organ prolapse repair using a transvaginal mesh: the experience in Sherbooke, Quebec.

Objective: The objective was to report our experience on the implantation of the Prolift system since 2005.

Methods: Fifty-six patients were operated on between July 2005 and August 2008 by 1 surgeon. The patients were implanted with the transvaginal mesh, the Prolift system, for the treatment of recurrent or high-grade (Baden-Walker stage III or IV) multiple compartment pelvic organ prolapse (POP) associated with symptoms. A concomitant anti-incontinence surgery was performed in 38 patients (68%).

Results: The population had a mean age of 68 (range 46-88), a body mass index of 27 (range 21-40) and a parity average of 3 (range 1-16). Previous POP repair had been performed in 17 patients (30%) and a hysterectomy in 43 (77%). The operating room time was on average 98 minutes (range 70-135), blood loss 81 mL (range 50-300) and hospital stay 3 days (range 1-10). With a median follow-up of 21 months, we found that the cure rate for POP was 91% (48/53) and the reoperation rate was 8% (4/53). Perioperative complications included 1 rectal laceration and 1 prolonged bleeding. Short-term postoperative complications included 10 episodes of transient urinary retention that required immediate tape release in 4 patients. Long-term complications included 5 POP recurrences, 2 low grade and 3 high grade.

Conclusion: The Prolift system appears to be a relatively safe and effective alternative to conventional surgeries for the treatment of recurrent or high-grade multiple compartment POP, because of a high mid-term cure rate and a satisfactory complication profile. However, long-term follow-up is still needed to confirm these results.