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International Urogynecology Journal

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01-10-2012 | Original Article

Prolapse repair using the Elevate™ kit: prospective study on 70 patients

Authors: H. Azaïs, C. Jean Charles, P. Delporte, P. Debodinance

Published in: International Urogynecology Journal | Issue 10/2012

Abstract

Introduction and hypothesis

The aim of this study was to examine the anatomical and functional results of prolapse repair by a vaginal approach using the Elevate kit.

Methods

This was a prospective study of 70 patients presenting with symptomatic urogenital prolapse. Twenty Elevate Anterior, 16 Posterior, and 34 Anterior and Posterior repair systems were placed. Perioperative and postoperative complications were assessed. The patients were interviewed at 2 months and 1 year post-surgery.

Results

Recurrences were recorded in 21 patients (31.3%) at the 1-year follow-up. However, at the 1-year follow-up, there were 14 cases (20.9%) of direct recurrence (two anterior, two posterior, and ten combined anterior and posterior) compared with seven cases (10.4%) of indirect recurrence. Of the 21 failures (stage ≥2), 13 were stage 2 with the leading edge above the hymen. None of the patients underwent revision surgery. The exposure rate was 4.5%. The anterior and posterior shrinkage rates were 68.7% and 31.9%, respectively. There were four cases of de novo dyspareunia. Patients reported a significant decrease in the impact of pelvic floor distress on the PFIQ-7 questionnaire, but an improvement on the PFDI-20. There was no improvement in sexual function (PISQ-12).

Conclusions

The Elevate™ kit is associated with satisfactory functional results. However, the anatomical results require ongoing evaluation.

Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF (1999) Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180(2):299–305PubMedCrossRef

Swift SE (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol 183(2):277–285PubMedCrossRef

Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89(4):501–506PubMedCrossRef

Shull BL (1999) Pelvic organ prolapse: anterior, superior, and posterior vaginal segment defects. Am J Obstet Gynecol 181(1):6–11PubMedCrossRef

Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185(6):1299–1304, discussion 304-6PubMedCrossRef

Shah AD, Kohli N, Rajan SS, Hoyte L (2008) The age distribution, rates, and types of surgery for pelvic organ prolapse in the U.S. Int Urogynecol J Pelvic Floor Dysfunct 19:421–428PubMedCrossRef

Sand PK, Koduri S, Lobel RW et al (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1362PubMedCrossRef

Nguyen JN, Burchette RJ (2008) Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 111:891–898PubMedCrossRef

Altman D, Vayrynen T, Ellstrom Engh M, Axelsen S, Falconer C et al (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364:1826–1836PubMedCrossRef

10.

Baessler K, Maher CF (2006) Mesh augmentation during pelvic- floor reconstructive surgery: risks and benefits. Curr Opin Obstet Gynecol 18:560–566PubMedCrossRef

11.

Walters MD (2003) The use and misuse of prosthetic materials in reconstructive pelvic surgery: does the evidence support our surgical practice? Int Urogynecol J 14:365–366CrossRef

12.

Nygaard I (2007) Marketed vaginal mesh kits: rampant experimentation or improved quality of care? Thoughts following the 2006 AUGS meeting by AUGS president Ingrid Nygaard, M.D. Int Urogynecol J 18:483–484CrossRef

13.

Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. BJOG 111:831–836PubMedCrossRef

14.

Achtari C, Hiscock R, O’Reilly BA, Schierlitz L, Dwyer PL (2005) Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene/polyglactin 910 (Vypro II) mesh. Int Urogynecol J 16:389–394CrossRef

15.

Fatton B, Amblard J, Debodinance P, Cosson M, Jacquetin B (2007) Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (ProliftTM technique)—a case series multicentric study. Int Urogynecol J 18:743–752CrossRef

16.

Parker MC, Phillips RK (1993) Repair of rectocoele using Marlex mesh. Ann R Coll Surg Engl 75:193–194PubMed

17.

Watson SJ, Loder PB, Halligan S, Bartram CI, Kamm MA, Phillips RK (1996) Transperineal repair of symptomatic rectocele with Marlex mesh: a clinical, physiological and radiologic assessment of treatment. J Am Coll Surg 183:257–261PubMed

18.

Flood CG, Drutz HP, Waja L (1998) Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J 9:200–204CrossRef

19.

Beets GL, Go PM, van Mameren H (1996) Foreign body reactions to monofilament and braided polypropylene mesh used as preperitoneal implants in pigs. Eur J Surg 162:823–825PubMed

20.

Dietz HP, Vancaillie P, Svehla M, Walsh W, Steensma AB, Vancaillie TG (2003) Mechanical properties of urogynecologic implant materials. Int Urogynecol J 14:239–243CrossRef

21.

Debodinance P, Berrocal J, Clave H, Cosson M, Garbin O, Jacquetin B, Rosenthal C, Salet-Lizee D, Villet R (2004) Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh. J Gynecol Obstet Biol Reprod 33:577–588 [article in French]CrossRef

22.

de Tayrac R, Picone O, Chauveaud-Lambling A, Fernandez H (2006) A 2-year anatomical and functional assessment of transvaginal rectocele repair using a polypropylene mesh. Int Urogynecol J 17:100–105CrossRef

23.

Falconer C, Soderberg M, Blomgren B, Ulmsten U (2001) Influence of different sling materials on connective tissue metabolism in stress urinary incontinent women. Int Urogynecol J 12:S19–S23CrossRef

24.

Walter JE, Lovatsis D, Easton W et al (2011) Transvaginal mesh procedures for pelvic organ prolapse. J Obstet Gynaecol Can 33(2):168–174PubMed

25.

Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17PubMedCrossRef

26.

Long CY, Hsu CS, Jang MY, Liu CM, Chiang PH, Tsai EM (2010) Comparison of clinical outcome and urodynamic findings using “Perigee and/or Apogee” versus “Prolift anterior and/or posterior” system devices for the treatment of pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 22(2):233–239

27.

Abdel-Fattah M, Ramsay I (2008) Retrospective multicentre study of the new minimally invasive mesh repair devices for pelvic organ prolapse. BJOG 115(1):22–30PubMed

28.

Jacquetin B, Fatton B, Rosenthal C et al (2010) Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 3-year prospective follow-up study. Int Urogynecol J Pelvic Floor Dysfunct 21(12):1455–1462CrossRef

29.

Vaiyapuri GR, Han HC, Lee LC, Tseng LA, Wong HF (2011) Use of the Gynecare Prolift(R) system in surgery for pelvic organ prolapse: 1-year outcome. Int Urogynecol J Pelvic Floor Dysfunct 22(7):869–877CrossRef

30.

Simon M, Debodinance P (2011) Vaginal prolapse repair using the Prolift kit: a registry of 100 successive cases. Eur J Obstet Gynecol Reprod Biol 158(1):104–109PubMedCrossRef

31.

Collinet P, Belot F, Debodinance P, Ha Duc E, Lucot JP, Cosson M (2006) Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct 17(4):315–320PubMedCrossRef

32.

Jia X, Glazener C, Mowatt G et al (2008) Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta-analysis. BJOG 115(11):1350–1361PubMedCrossRef

33.

Debodinance P, Berrocal J, Clave H et al (2004) Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh. J Gynecol Obstet Biol Reprod (Paris) 33(7):577–588CrossRef

34.

Jacquetin B, Cosson M (2009) Complications of vaginal mesh: our experience. Int Urogynecol J Pelvic Floor Dysfunct 20(8):893–896PubMedCrossRef

35.

Altman D, Elmer C, Kiilholma P, Kinne I, Tegerstedt G, Falconer C (2009) Sexual dysfunction after trocar-guided transvaginal mesh repair of pelvic organ prolapse. Obstet Gynecol 113(1):127–133PubMed

36.

Gauruder-Burmester A, Koutouzidou P, Tunn R (2009) Effect of vaginal polypropylene mesh implants on sexual function. Eur J Obstet Gynecol Reprod Biol 142(1):76–80PubMedCrossRef

Title: Prolapse repair using the Elevate™ kit: prospective study on 70 patients
Authors: H. Azaïs
C. Jean Charles
P. Delporte
P. Debodinance
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 10/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-012-1673-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prolapse repair using the Elevate™ kit: prospective study on 70 patients

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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