Stephen T Jeffery1, Brita S Kortz2, Dakalo Muavha1, Nina N Stolwijk3, Lamees Ras1, Jan-Paul W R Roovers3. 1. Department of Obstetrics and Gynecology, Groote Schuur Hospital, University of Cape Town, South Africa (Drs. Jeffery, Muavha, and Ras). 2. Department of Obstetrics and Gynecology, Amsterdam University Medical Center, Amsterdam, The Netherlands (Ms. Kortz, Ms. Stolwijk, and Dr. Roovers). Electronic address: b.s.kortz@amc.uva.nl. 3. Department of Obstetrics and Gynecology, Amsterdam University Medical Center, Amsterdam, The Netherlands (Ms. Kortz, Ms. Stolwijk, and Dr. Roovers).
Abstract
STUDY OBJECTIVE: To determine complications and related reintervention rates associated with use of the Uphold Vaginal Support System (Boston Scientific, Boston, MA) for symptomatic vaginal apical prolapse. DESIGN: A multicenter retrospective study. SETTING: Two teaching hospitals. PATIENTS: Fifty-nine women with symptomatic vaginal apical prolapse. INTERVENTION: Vaginal apical prolapse surgery using the Uphold Mesh Kit system with or without other concomitant procedures. MEASUREMENTS AND MAIN RESULTS: A chart review was performed, including the following parameters: perioperative and postoperative complications, repeat surgery, and recurrence rate. A total of 59 patients met the criteria for inclusion in the study. Bladder perforation occurred perioperatively in 1 patient. Postoperative voiding difficulties were observed in 16 patients (27.1%), including 9 women (15.2%) who left the hospital with an indwelling catheter in place. There were 5 cases (8.5%) of transient groin pain, all of which resolved spontaneously. One patient developed a vaginal hematoma. Nine women (15%) required reoperation, including 4 (6.7%) because of recurrent prolapse and 1 (2%) for pelvic pain considered related to the mesh. Three patients (5%) required release of a midurethral sling (MUS) that had been placed concomitantly with the Uphold system. Two patients (3%) required a MUS for de novo stress incontinence. CONCLUSION: Use of the Uphold Vaginal Support System for symptomatic vaginal apical prolapse was associated with a significant risk of obstructed micturition. In our study population, 15% required repeat surgery, mainly for recurrent pelvic organ prolapse and de novo stress urinary incontinence. No surgical-related complication resulted in long-term morbidity.
STUDY OBJECTIVE: To determine complications and related reintervention rates associated with use of the Uphold Vaginal Support System (Boston Scientific, Boston, MA) for symptomatic vaginal apical prolapse. DESIGN: A multicenter retrospective study. SETTING: Two teaching hospitals. PATIENTS: Fifty-nine women with symptomatic vaginal apical prolapse. INTERVENTION: Vaginal apical prolapse surgery using the Uphold Mesh Kit system with or without other concomitant procedures. MEASUREMENTS AND MAIN RESULTS: A chart review was performed, including the following parameters: perioperative and postoperative complications, repeat surgery, and recurrence rate. A total of 59 patients met the criteria for inclusion in the study. Bladder perforation occurred perioperatively in 1 patient. Postoperative voiding difficulties were observed in 16 patients (27.1%), including 9 women (15.2%) who left the hospital with an indwelling catheter in place. There were 5 cases (8.5%) of transient groin pain, all of which resolved spontaneously. One patient developed a vaginal hematoma. Nine women (15%) required reoperation, including 4 (6.7%) because of recurrent prolapse and 1 (2%) for pelvic pain considered related to the mesh. Three patients (5%) required release of a midurethral sling (MUS) that had been placed concomitantly with the Uphold system. Two patients (3%) required a MUS for de novo stress incontinence. CONCLUSION: Use of the Uphold Vaginal Support System for symptomatic vaginal apical prolapse was associated with a significant risk of obstructed micturition. In our study population, 15% required repeat surgery, mainly for recurrent pelvic organ prolapse and de novo stress urinary incontinence. No surgical-related complication resulted in long-term morbidity.
Authors: Edward Morcos; Christian Falconer; Emilie Toresson Grip; Kirk Geale; Katarina Hellgren; Georgios Poutakidis; Daniel Altman Journal: Int Urogynecol J Date: 2021-02-26 Impact factor: 2.894