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International Urogynecology Journal

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01-09-2016 | Original Article

Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?

Authors: Lin Li Ow, Yik N. Lim, Peter L. Dwyer, Debjyoti Karmakar, Christine Murray, Elizabeth Thomas, Anna Rosamilia

Published in: International Urogynecology Journal | Issue 9/2016

Abstract

Introduction and hypothesis

The objective of this study was to assess outcomes in native tissue (NT) and transvaginal mesh (TVM) repair in women with recurrent prolapse.

Methods

A retrospective two-group observational study of 237 women who underwent prolapse repair after failed NT repair in two tertiary hospitals. A primary outcome of “success” was defined using a composite outcome of no vaginal bulge symptoms, no anatomical recurrence in the same compartment beyond the hymen (0 cm on POPQ) and no surgical re-treatment for prolapse in the same compartment. Secondary outcomes assessed included re-operation for prolapse in the same compartment, dyspareunia and mesh-related complications.

Results

Of a total of 336 repairs, 196 were performed in the anterior compartment and 140 in the posterior compartment. Compared with the TVM groups, women undergoing repeat NT repair were more likely to experience anatomical recurrence (anterior 40.9 % vs 25 %, p = 0.02, posterior 25.3 % vs 7.5 %, p = 0.01), report vaginal bulge (anterior 34.1 % vs 12 %, p < 0.01, posterior 24.1 % vs 7.5 %, p 0.02) and had a higher prolapse re-operation rate (anterior 23.9 % vs 7.4 %, p < 0.01, posterior 19.5 % vs 7.5 %, p = 0.08). Using composite outcomes, the success rate was higher with TVM repair in both compartments (anterior 34.2 % vs 13.6 %, p <0.01, posterior 56.6 % vs 23.0 %, p <0.01). Re-operations for mesh exposure were 9.3 % anteriorly and 15.1 % posteriorly. Although the number of women requiring a prolapse re-operation is lower in the TVM group, the overall re-operation rate was not significantly different when procedures to correct mesh complications were included.

Conclusions

Although the success rate is better with the use of TVM for recurrent prolapse, the total re-operation rates are similar when mesh complication-related surgeries are included.

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Title: Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?
Authors: Lin Li Ow
Yik N. Lim
Peter L. Dwyer
Debjyoti Karmakar
Christine Murray
Elizabeth Thomas
Anna Rosamilia
Publication date: 01-09-2016
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 9/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-016-3069-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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