Retrospective multicentre study of the new minimally invasive mesh repair devices for pelvic organ prolapse.

OBJECTIVES: To assess the complications and short-term outcomes of prolapse repair mesh devices used in the management of female pelvic organ prolapse (POP).
DESIGN: Retrospective cohort study.
SETTING: Multicentre study involving a tertiary referral urogynaecology unit and two district general hospitals. POPULATION: 329 women who underwent surgical management of prolapse with various prolapse repair mesh devices in the period between January 2005 and December 2006.
METHODS: Women were identified from theatre records. An independent clinician performed a case notes review during the period March to May 2007. MAIN OUTCOME MEASURES: Complication rates and the short-term cure at 3-month follow-up (defined as </=stage I prolapse on the POP-Q or Baden Walker scoring systems).
RESULTS: A total of 289 women were included: 219 (76%) used the Gynecare prolapse repair mesh devices, while 70 women (24%) used the American Medical Systems prolapse repair mesh devices. Operative complications included: bladder injury (1.6%), rectal injury (1.1%) and two women with serious vascular injuries. Postoperative complications included: buttock pain (5.2%), vaginal erosion (10%), one woman with bladder erosion and two women (0.7%) with serious infection, leading to necrotising fasciitis in one woman. Short-term cure rates in different groups varied from 94 to 100%, depending on vaginal compartment and device used. In total 15 women (5%) had persistent prolapse at 3-month follow up.
CONCLUSION: The new prolapse repair mesh devices demonstrate excellent short-term cure and low morbidity rates. However, some complications are serious and require highly specialised management. Rigorous evaluation by means of independent, controlled studies is urgently required.