INTRODUCTION AND HYPOTHESIS: Here we describe anatomic and quality of life (QOL) outcomes of an anterior and apical compartment prolapse repair involving a reduced mesh implant size and apex-only fixation. METHODS: One hundred and fifteen patients undergoing the repair at a single urogynecology center were assessed using the Pelvic Organ Prolapse Quantification (POP-Q) and inpatient chart reviews. A horizontal incision eliminated overlap with the mesh, and each sacrospinous ligament was approached anteriorly by blunt dissection. Recurrence was defined as apical (C), or anterior (Aa or Ba) ≥0, and secondary analyses were performed using POP-Q ≥ -1 as the anatomic threshold. Pelvic Floor Distress Inventory (PFDI), Surgical Satisfaction Questionnaires (SSQ) and a dyspareunia symptom scale were analyzed pre- and postoperatively. RESULTS: Fifty-three women with uterus in situ demonstrated a combined anterior-apical recurrence rate of 1.89 %, including no anterior (Ba ≥ -1) and one apical (C ≥ -1) recurrence. Forty-seven women undergoing repair for vault prolapse had recurrence rates ranging from 0 % in those with prior hysterectomy to 4.2 % in those undergoing concurrent hysterectomy. The rate of mesh exposure was 3/115 (2.6 %), including two in women with concurrent hysterectomy. Self-reported dyspareunia was more common preoperatively (13.4 %) than postoperatively (9.3 %). PFDI scores improved in all domains, and 93 % completing the SSQ reported they were satisfied and would choose the surgery again. CONCLUSIONS: This technique resulted in successful outcomes within both anterior and apical compartments with a low rate of mesh complication, and no cases required mesh removal or hospital readmission. High rates of satisfaction and improved condition-specific QOL were observed.
INTRODUCTION AND HYPOTHESIS: Here we describe anatomic and quality of life (QOL) outcomes of an anterior and apical compartment prolapse repair involving a reduced mesh implant size and apex-only fixation. METHODS: One hundred and fifteen patients undergoing the repair at a single urogynecology center were assessed using the Pelvic Organ Prolapse Quantification (POP-Q) and inpatient chart reviews. A horizontal incision eliminated overlap with the mesh, and each sacrospinous ligament was approached anteriorly by blunt dissection. Recurrence was defined as apical (C), or anterior (Aa or Ba) ≥0, and secondary analyses were performed using POP-Q ≥ -1 as the anatomic threshold. Pelvic Floor Distress Inventory (PFDI), Surgical Satisfaction Questionnaires (SSQ) and a dyspareunia symptom scale were analyzed pre- and postoperatively. RESULTS: Fifty-three women with uterus in situ demonstrated a combined anterior-apical recurrence rate of 1.89 %, including no anterior (Ba ≥ -1) and one apical (C ≥ -1) recurrence. Forty-seven women undergoing repair for vault prolapse had recurrence rates ranging from 0 % in those with prior hysterectomy to 4.2 % in those undergoing concurrent hysterectomy. The rate of mesh exposure was 3/115 (2.6 %), including two in women with concurrent hysterectomy. Self-reported dyspareunia was more common preoperatively (13.4 %) than postoperatively (9.3 %). PFDI scores improved in all domains, and 93 % completing the SSQ reported they were satisfied and would choose the surgery again. CONCLUSIONS: This technique resulted in successful outcomes within both anterior and apical compartments with a low rate of mesh complication, and no cases required mesh removal or hospital readmission. High rates of satisfaction and improved condition-specific QOL were observed.
Authors: Sylvia M Botros; Peter K Sand; Jennifer L Beaumont; Yoram Abramov; Jay James Miller; Roger P Goldberg Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2009-06-17
Authors: Renaud de Tayrac; Laurent Boileau; Jean-François Fara; François Monneins; Charles Raini; Pierre Costa Journal: Int Urogynecol J Date: 2010-03 Impact factor: 2.894
Authors: P K Sand; S Koduri; R W Lobel; H A Winkler; J Tomezsko; P J Culligan; R Goldberg Journal: Am J Obstet Gynecol Date: 2001-06 Impact factor: 8.661
Authors: Kristin Rooney; Kimberly Kenton; Elizabeth R Mueller; Mary Pat FitzGerald; Linda Brubaker Journal: Am J Obstet Gynecol Date: 2006-12 Impact factor: 8.661
Authors: Cheryl B Iglesia; Andrew I Sokol; Eric R Sokol; Bela I Kudish; Robert E Gutman; Joanna L Peterson; Susan Shott Journal: Obstet Gynecol Date: 2010-08 Impact factor: 7.661
Authors: Linda Brubaker; Ingrid Nygaard; Holly E Richter; Anthony Visco; Anne M Weber; Geoffrey W Cundiff; Paul Fine; Chiara Ghetti; Morton B Brown Journal: Obstet Gynecol Date: 2008-07 Impact factor: 7.661
Authors: Reijo Hiltunen; Kari Nieminen; Teuvo Takala; Eila Heiskanen; Mauri Merikari; Kirsti Niemi; Pentti K Heinonen Journal: Obstet Gynecol Date: 2007-08 Impact factor: 7.661
Authors: Geoffrey W Cundiff; Edward Varner; Anthony G Visco; Halina M Zyczynski; Charles W Nager; Peggy A Norton; Joseph Schaffer; Morton B Brown; Linda Brubaker Journal: Am J Obstet Gynecol Date: 2008-10-31 Impact factor: 8.661
Authors: Charles W Nager; Halina Zyczynski; Rebecca G Rogers; Matthew D Barber; Holly E Richter; Anthony G Visco; Charles R Rardin; Heidi Harvie; Dennis Wallace; Susan F Meikle Journal: Female Pelvic Med Reconstr Surg Date: 2016 Jul-Aug Impact factor: 2.091
Authors: Daniel Altman; Tomi S Mikkola; Karl Möller Bek; Päivi Rahkola-Soisalo; Jonas Gunnarsson; Marie Ellström Engh; Christian Falconer Journal: Int Urogynecol J Date: 2016-02-13 Impact factor: 2.894