Brief Article
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World J Obstet Gynecol. Nov 10, 2013; 2(4): 176-180
Published online Nov 10, 2013. doi: 10.5317/wjog.v2.i4.176
Surgical repair of pelvic organ prolapse and follow-up: An institutional multi-center experience
Sarah Gustapane, Martina Leombroni, Eleonora Falò, Alessandro Santarelli, Franco Frondaroli, Marco Liberati, Emanuele Perrone, Andrea Tinelli
Sarah Gustapane, Martina Leombroni, Eleonora Falò, Alessandro Santarelli, Franco Frondaroli, Marco Liberati, Department of Obstetrics and Gynaecology, Santissima Annunziata Hospital, 66100 Chieti, Italy
Emanuele Perrone, Department of Obstetrics and Gynaecology, University of Perugia, 6100 Perugia, Italy
Andrea Tinelli, Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, 73100 Lecce, Italy
Author contributions: Gustapane S contributed to this study as a surgeon, study planner, data analyzer and writer of the paper; Leombroni M contributed to this study as a study planner, data collector and analyzer, and writer of the paper; Falò E contributed to this study as a surgeon and writer of the paper; Santarelli A, Frondaroli F and Liberati M contributed to this study as surgeons; Perrone E and Tinelli A contributed to this study as final reviewers of the paper.
Correspondence to: Sarah Gustapane, MD, Department of Obstetrics and Gynaecology, Santissima Annunziata Hospital, via dei Vestini, 66100 Chieti, Italy. sarahgustapane@gmail.com
Telephone: +39-83-2661115 Fax: +39-83-2661115
Received: May 9, 2013
Revised: August 22, 2013
Accepted: September 14, 2013
Published online: November 10, 2013
Processing time: 192 Days and 15.9 Hours
Abstract

AIM: To investigate the effects of the Elevate Anterior and Posterior transvaginal mesh procedure on 30 patients affected by pelvic organ prolapse (POP) at 12 mo follow-up.

METHODS: Between September 2011 and September 2012, a prospective multicenter observational study enrolled 30 consecutive patients with POP-Q ≥ stage II. After a preoperative evaluation, patients underwent prolapse repair utilizing the Elevate Anterior and Posterior Prolapse Repair System (American Medical Systems, Minnetonka, MN, United States). Operative technique was standardized and performed by the same surgical team under spinal or general anesthesia. Patients were evaluated postoperatively at 1, 3, 6 and 12 mo.

RESULTS: All 30 patients completed the 12 mo follow-up. The mean age was 65.3 years (range 49-81 years) and average hospital stay was 4.5 d. The mean operative time was 65 min (range 40-120 min). Related adverse events reported were mesh extrusions (6.7%) and post void residual urine volume (13.3%). There were no visceral injuries, no infection of the mesh, and no symptoms of recurrent prolapse. All quality-of-life scores significantly improved from baseline.

CONCLUSION: One year’s follow-up of our 30 patients confirms the safety and the efficacy of the Elevate Anterior and Posterior transvaginal mesh procedure for POP treatment. Our final results are comforting but longer term follow-up is ongoing.

Keywords: Pelvic organ prolapse; Pelvic organ prolapse; Mesh; Vaginal mesh erosion

Core tip: Our initial results show that the vaginal repair of anterior/apical and posterior wall prolapse utilizing a wall mesh placed via the Elevate system is an effective, safe and minimally invasive procedure for the treatment pelvic organ prolapse and shows excellent anatomical and functional results. Recent studies of the anatomical and physiological pelvic floor characteristics favored new generation prosthetic surgical techniques with advanced tools and biocompatible mesh in order to allow lower recurrence rates. Our final results are interesting and comforting but longer term follow-up is ongoing.