Polypropylene mesh used for adjuvant reconstructive surgical treatment of advanced pelvic organ prolapse

To elucidate the outcome of transvaginal pelvic reconstructive surgery using polypropylene mesh (Gynemesh; Ethicon, Somerville, NJ, USA) for patients with pelvic organ prolapse (POP) stage III or IV.

Thirty-nine patients who underwent transvaginal pelvic reconstructive surgery from September 2004 through December 2005 were collected and analyzed. All patients underwent pelvic reconstructive surgery with anterior and posterior colporrhaphy with Gynemesh reinforcement.

The average age of the patients was 64.1 years and average parity was 3.9. Thirty-four patients had Pelvic Organ Prolapse Quantification (POP-Q) stage 0, four patients had stage I, and one patient had stage II at a median follow-up time of 18 months postoperatively. The success rate was 97.4%. Only one patient (2.6%) had recurrent genital prolapse (stage II) postoperatively. Quality of life was evaluated before and after the operations. The mean scores on the Urinary Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) were 5.0 ± 4.6 and 8.7 ± 6.2 before the operation and 3.0 ± 4.7 and 3.2 ± 5.6 after the operation, respectively (P = 0.03 and 0.01). The complication rate was 10.3 %, including one vaginal mesh erosion (2.6%), one dyspareunia (2.6%) and two prolonged bladder drainage (longer than 14 days, 5.1%). The mean duration of postoperative bladder drainage was 2.4 days and mean postoperative hospital stay was 5.1 days. Neither long-term nor major complication was identified.

Transvaginal pelvic reconstructive surgery with polypropylene mesh reinforcement is a safe and effective procedure for POP on 1.5 years' follow- up. It also has positive influence on quality of life.