Retrospective multicentre study of the new minimally invasive mesh repair devices for pelvic organ prolapse

Authors

  • M Abdel-fattah,

    Corresponding author
    1. Urogynaecology Unit, Southern General Hospital, Greater Glasgow and Clyde Health Board, Glasgow, UK
      Dr M Abdel-fattah, Urogynaecology Unit, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK. Email mohamed.abdelfattah@sgh.scot.nhs.uk
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  • I Ramsay,

    1. Urogynaecology Unit, Southern General Hospital, Greater Glasgow and Clyde Health Board, Glasgow, UK
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  • West of Scotland Study Group

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    • *

      West of Scotland Study Group: S Bjornsson (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), M Allam (Department of Obstetrics & Gynaecology, Wishaw General Hospital, Lanrkshire NHS Trust, Wishaw, UK), A Paterson (Department of Obstetrics & Gynaecology, Royal Alexandra Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), S Pringle (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), C Hardwick (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), J Tierney (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), HM Ali (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), R Hawthorn (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), Z Parveen (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), MU Lim (Department of Obstetrics & Gynaecology, Royal Alexandra Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), N Aedla (Urogynaecology Unit, Southern General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK), JS Sheridan (Interventional Radiology Department, Gartnavel General Hospital, Greater Glasgow & Clyde Health Board, Glasgow, UK).


Dr M Abdel-fattah, Urogynaecology Unit, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK. Email mohamed.abdelfattah@sgh.scot.nhs.uk

Abstract

Objectives  To assess the complications and short-term outcomes of prolapse repair mesh devices used in the management of female pelvic organ prolapse (POP).

Design  Retrospective cohort study.

Setting  Multicentre study involving a tertiary referral urogynaecology unit and two district general hospitals.

Population  329 women who underwent surgical management of prolapse with various prolapse repair mesh devices in the period between January 2005 and December 2006.

Methods  Women were identified from theatre records. An independent clinician performed a case notes review during the period March to May 2007.

Main Outcome Measures  Complication rates and the short-term cure at 3-month follow-up (defined as ≤stage I prolapse on the POP-Q or Baden Walker scoring systems).

Results  A total of 289 women were included: 219 (76%) used the Gynecare prolapse repair mesh devices, while 70 women (24%) used the American Medical Systems prolapse repair mesh devices. Operative complications included: bladder injury (1.6%), rectal injury (1.1%) and two women with serious vascular injuries. Postoperative complications included: buttock pain (5.2%), vaginal erosion (10%), one woman with bladder erosion and two women (0.7%) with serious infection, leading to necrotising fasciitis in one woman. Short-term cure rates in different groups varied from 94 to 100%, depending on vaginal compartment and device used. In total 15 women (5%) had persistent prolapse at 3-month follow up.

Conclusion  The new prolapse repair mesh devices demonstrate excellent short-term cure and low morbidity rates. However, some complications are serious and require highly specialised management. Rigorous evaluation by means of independent, controlled studies is urgently required.

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