Long-term functional outcomes following mesh-augmented posterior vaginal prolapse repair

Abstract

ObjectiveTo assess long-term patient-centered functional outcomes following posterior vaginal wall repair using mesh implants. MethodThe 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. ResultsIn 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. ConclusionThe 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.