Adi Y Weintraub1, Talia Friedman2, Yael Baumfeld1, Joerg Neymeyer3, Menahem Neuman4, Haim Krissi5. 1. Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel. 2. Assuta Medical Centers, Tel Aviv and Rishon LeZion, Israel. 3. Department of Urology, Charitè University, Berlin, Germany. 4. Assuta Medical Centers, Tel Aviv and Rishon LeZion, Israel; Urogynecology, Department of Obstetrics and Gynecology, Galilee Hospital, Center, affiliated with Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel. 5. Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: haimkr@clalit.org.il.
Abstract
OBJECTIVE: To assess long-term patient-centered functional outcomes following posterior vaginal wall repair using mesh implants. METHOD: The present prospective telephone interview study enrolled a cohort of women who had undergone posterior vaginal wall repair with mesh between January 1, 2006 and February 28, 2009, at a single center in Israel. Patients were asked to report long-term outcomes, and demographic, clinical, intraoperative, and postoperative follow-up data were retrieved from patients' medical files. Multivariable logistic regression models were used to asses associations between baseline characteristics and long-term outcomes. RESULTS: In total, 102 patients were contacted, with 80 (78.4%) at 61-83months after surgery agreeing to participate. A recurrence of prolapse symptoms was reported by 14 patients (18%) (12 required a corrective procedure), mesh had been removed from two patients owing to erosion/extrusion, and two others had undergone removal of granulation tissue. Long-term, bothersome symptoms were reported by 13 (16%) patients. Parity and previous hysterectomy were associated with lower odds of long-term adverse outcomes, and the location of the apical (C/D) pelvic organ prolapse quantification point and a change in its position following surgery were associated with increased odds of adverse outcomes. CONCLUSION: The long-term adverse-outcome rate was low for patients who underwent posterior vaginal mesh augmentation. These results highlight the importance of apical support for good long-term functional outcomes.
OBJECTIVE: To assess long-term patient-centered functional outcomes following posterior vaginal wall repair using mesh implants. METHOD: The present prospective telephone interview study enrolled a cohort of women who had undergone posterior vaginal wall repair with mesh between January 1, 2006 and February 28, 2009, at a single center in Israel. Patients were asked to report long-term outcomes, and demographic, clinical, intraoperative, and postoperative follow-up data were retrieved from patients' medical files. Multivariable logistic regression models were used to asses associations between baseline characteristics and long-term outcomes. RESULTS: In total, 102 patients were contacted, with 80 (78.4%) at 61-83months after surgery agreeing to participate. A recurrence of prolapse symptoms was reported by 14 patients (18%) (12 required a corrective procedure), mesh had been removed from two patients owing to erosion/extrusion, and two others had undergone removal of granulation tissue. Long-term, bothersome symptoms were reported by 13 (16%) patients. Parity and previous hysterectomy were associated with lower odds of long-term adverse outcomes, and the location of the apical (C/D) pelvic organ prolapse quantification point and a change in its position following surgery were associated with increased odds of adverse outcomes. CONCLUSION: The long-term adverse-outcome rate was low for patients who underwent posterior vaginal mesh augmentation. These results highlight the importance of apical support for good long-term functional outcomes.