Outcome of Repeat Surgery for Genital Prolapse using Prolift-Mesh

Abstract

Introduction: Urogenital prolapse can have a significant impact on quality of life. The life time risk of requiring surgery for urogenital prolapse is 11%. Prolift mesh has recently been introduced to reduce repeat operation rate and for long-term benefit Objective: To evaluate the outcome of the treatment of urogenital prolapse with synthetic mesh. Methods: A retrospective review of case notes of all women who underwent prolift mesh insertion for prolapse between July 2004 and June 2005, at Royal Alexandra Hospital Paisley UK. We looked at the presenting complaints, previous operation, intraoperative complications and complications at six weeks and six months follow-up. Results: Twenty-two procedures were carried out in the twelve months period. Age of the patients ranged from 55 to 82 years (median 64yrs). Eleven had anterior Prolift (50%), Seven had posterior Prolift 31.8% and four total Prolift 18%. There were no intraoperative complications. Operation times range from 40-60minutes, while the blood loss was 400millilitres on average. All the patients had previous surgery for prolapse. Eight patients had anterior repair, six patients had posterior repair, and three patients had abdominal hysterectomy. Vaginal hysterectomy was carried out with mesh insertion as a concomitant procedure in seven cases (31.25%).All patients were seen at six weeks and six months after the surgery. Complications rate included mesh erosion one patient and suture material protruding in the vagina one patient, one patient had failed prolift-operation. All the twenty-one patients were cured giving 95.4% success rate. Conclusion: The use of prolene mesh in repeat pelvic reconstructive surgery was associated with good outcome and minimal complications in this study.