• Aust N Z J Obstet Gynaecol · Feb 2013

    Comparative Study

    Long-term treatment outcomes of transvaginal mesh surgery versus anterior-posterior colporrhaphy for pelvic organ prolapse.

    • Qi Cao, Yi-Song Chen, Jing-Xin Ding, Chang-Dong Hu, Wei-Wei Feng, Wei-Guo Hu, and Ke-Qin Hua.
    • Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
    • Aust N Z J Obstet Gynaecol. 2013 Feb 1;53(1):79-85.

    BackgroundIn spite of rapid growth in the use of vaginally placed mesh in pelvic reconstructive surgery, there are few reports on the long-term efficacy and safety of mesh-augmented repairs.AimsTo compare the long-term outcomes of modified pelvic floor reconstructive surgery with mesh (MPFR) versus traditional anterior-posterior colporrhaphy (APC) for the treatment of pelvic organ prolapse (POP).MethodsThis retrospective cohort study involved 158 women who underwent surgical management of prolapse with MPFR (n = 84) or APC (n = 74) in the period between January 2007 and June 2008. Main outcome measures included pelvic organ prolapse quantification measurement, Short Form-20 Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) questionnaires, perioperative outcomes, complications and a personal interview about urinary and sexual symptoms. Statistical analysis included comparison of means (Wilcoxon test or Student's t-test) and proportions (χ(2) test).ResultsAnatomical success rate for MPFR and APC was 88.1 versus 64.9% (P = 0.001), with a median follow-up of 55 versus 56 months (range 49-66 months, P = 0.341). Both operations significantly improved quality of life, and a greater improvement was seen in MPFR group than in APC group (P = 0.013). Complication rates did not differ significantly between the two groups. The mesh erosion rate was 3.6%.ConclusionModified pelvic floor reconstructive surgery with mesh had better anatomical and functional outcomes than APC at 4-5 years postoperation, as an alternative, cheap and effective treatment option to mesh kits for the management of POP.© 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

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