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Keywords:

  • pelvic organ prolapse;
  • pelvic reconstructive surgery;
  • Prolift;
  • stress urinary incontinence;
  • urinary symptom

Abstract

Aim:  To assess the outcome of the Prolift Gynecare (Ethicon, Somerville, NJ, USA) mesh repair in the treatment of pelvic organ prolapse. This includes the anatomical success, complication rate and effect on associated lower urinary tract symptoms.

Material and Methods:  Retrospective case analysis of the above outcomes of 41 Prolift mesh repairs performed on 40 women over a 5-year period by a single surgeon in a private hospital in Australia.

Results:  Successful anatomical correction and bulge symptom resolution were observed in 100% (2/2), 91.6% (11/12) and 100% (27/27) of anterior, posterior and total Prolift, respectively. Prolapse in a non-treated compartment occurred in one woman. Two patients developed postoperative hematomas requiring surgical evacuation; one of whom developed urinary retention for 2 weeks. Preoperative urinary symptoms were reported in 35/40 (92%) of women, 8 of whom reported only urge symptoms and experienced complete resolution after Prolift. Resolution of stress urinary incontinence in women who had urodynamic stress incontinence with and without urge symptoms was reported in 60% (12/20) and 20% (1/5), respectively. This represented 62.5% (10/16) and 33.3% (3/9) of women who had total Prolift and posterior Prolift respectively. Average follow-up periods were 7 and 39 weeks in 38 and 18 women, respectively.

Conclusion:  This study shows that Prolift procedure is safe and effective in women with severe pelvic organ prolapse with resolution of most of the bulge and urinary urge symptoms. Total Prolift was effective in the treatment of associated mixed urinary incontinence.