Tension-free Polypropylene Mesh-related Surgical Repair for Pelvic Organ Prolapse has a Good Anatomic Success Rate but a High Risk of Complications

摘要

Background:Food and Drug Administration announcements have highlighted the standard rate of mesh-related complications.We aimed to report the short-term results and complications of tension-free polypropylene mesh (PROSIMATM) surgical repair of pelvic organ prolapse (POP) using the standard category (C),timing (T),and site (S) classification system.Methods:A prospective cohort study of 48 patients who underwent PROSIMATM mesh kit-related surgical repairs were followed for two years at Peking Union Medical College Hospital.Recurrence was defined as symptomatic POP quantification (POP-Q) Stage Ⅱ or higher (leading edge ≥-1 cm).The Patient Global Impression of Change Questionnaire,the Chinese version of the Pelvic Floor Impact Questionnaire short-form-7 and POP/Urinary Incontinence Sexual Questionnaire short-form-12 were used to evaluate the self-perception and sexual function of each patient.Mesh-related complications conformed to the International Urogynecological Association/International Continence Society joint terminology.The paired-sample t-test,one-way analysis of variance,Fisher's exact test,Kaplan-Meier survival analysis and log-rank test were used to analyze data.Results:All patients were followed up for≥1 2 months; 30 (62.5％) patients completed the 24 months study.We observed a 93.8％ (45/48) positive anatomical outcome rate at 12 months and 90.0％ (27/30) at 24 months.Recurrence most frequently involved the anterior compartment (P ＜ 0.05).Pelvic symptoms improved significantly from baseline (P ＜ 0.05),although the patients' impressions of change and sexual function were not satisfying.Vaginal complication was the main complication observed (35.4％,17/48).The survival analysis did not identify any relationship between vaginal complication and anatomical recurrent prolapse (POP-Q ≥ Stage Ⅱ) (P =0.653).Conclusions:Tension-free polypropylene mesh (PROSIMATM)-related surgical repair of POP has better short-term anatomical outcomes at the apical and posterior compartments,but a low patient satisfaction rate.The mesh complications were not the definitive cause of recurrence.