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.