Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse

To report the short- and intermediate- term outcome of safety and efficacy after abdominal-mesh sacrocolpopexy (MSC) for recurrent anterior, posterior and vault ('triple-compartment') pelvic organ prolapse (POP).

In a database review we identified non-neurogenic women who had MSC for recurrent triple-compartment POP and with a >or=6-month cystographic follow-up. The preoperative evaluation included a history, physical examination, Urogenital Distress Inventory (UDI-6) and visual analogue quality-of-life (QoL) questionnaires, urodynamic studies, and a standing lateral voiding cysto-urethrogram (VCUG) with rest-strain views. All surgery as performed by the same surgeon, using polypropylene (Marlex) mesh. Perioperative data, the VCUG at 6 months, and interval pelvic examinations were recorded.

Between 2000 and 2006, 29 postmenopausal women (Caucasian, mean age 64 years, sd 11) underwent MSC. The mean (sd, range) operative duration was 228 (75, 170-340) min, the estimated blood loss 150 (100) mL and the inpatient stay 3 (1) days. At a mean (sd) follow-up of 23 (16) months, the physical examination showed no evidence of POP of grade >or=2, with mean POP-Quantification scores of -2.8 (0.4), -2.9 (0.4) and -9.3 (0.8) for points A(a), A(p) and C, respectively. Two patients (8%) had evidence of grade >or=2 cystocele at the 6-month VCUG. After MSC, four of the six UDI and the QoL scores were significantly lower at the last follow-up than at baseline, with no change in sexual or defecatory function.

The objective and subjective improvement at the short and intermediate follow-up after MSC suggest that this is a safe and effective treatment for recurrent triple-compartment POP.