Morbidity of a Single Incision Transvaginal Mesh to Correct Apical Prolapse |
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| Institution: | 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);1. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Drs. Sunderji and Singh);2. Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada (Drs. Buitenhuis and Singh);3. Division of Anatomic Pathology, Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama (Dr. Lee);4. Division of Anatomical Pathology, University of Ottawa, Ottawa, Ontario, Canada (Dr. Purgina).;1. Department of Gynecology and Obstetrics (Drs. Pace, Petignat, and Dubuisson);2. Department of Radiology (Dr. Kalovidouri);3. Division of Clinical Pathology (Drs. Ghinescu and Tille), University Hospitals of Geneva, Geneva, Switzerland.;1. Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Drs. Cassling, Schiff, Louie, and Carey);2. Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington (Dr. Shay);3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Drs. Strassle and Voltzke).;1. Department of Cardiology, College of Medicine, Dong-A University, Busan, Republic of Korea;2. Global Clinical Trial Center, Dong-A University Hospital, Busan, Republic of Korea;3. Department of Cardiology, Kurashiki General Hospital, Okayama, Japan;4. Johns Hopkins University, Baltimore, MD, USA |
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| Abstract: | Study ObjectiveTo determine complications and related reintervention rates associated with use of the Uphold Vaginal Support System (Boston Scientific, Boston, MA) for symptomatic vaginal apical prolapse.DesignA multicenter retrospective study.SettingTwo teaching hospitals.PatientsFifty-nine women with symptomatic vaginal apical prolapse.InterventionVaginal apical prolapse surgery using the Uphold Mesh Kit system with or without other concomitant procedures.Measurements and Main ResultsA 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.ConclusionUse 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. |
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