Perioperative outcomes and prospective patient reported outcome measures for transvaginal mesh surgery.

Abstract

To determine perioperative morbidity associated with the transvaginal mesh and analyse patient reported outcome measures following transvaginal mesh surgery via a prospective cohort study. A retrospective review and a prospective cohort study of vaginal symptoms via a validated questionnaire (Ethically approved). 159 consecutive women who underwent transvaginal polypropylene mesh repair for pelvic organ prolapse from January 2009 to January 2012 by a single experienced urogynaecologist were identified using theatre records and formed the study population. The type and frequency of intraoperative and postoperative complications, mesh exposure rates and need for further surgery were recorded. 59/159 patients consented to complete both preoperative and postoperative assessment of vaginal symptoms using the validated International Consultation on Incontinence Modular Questionnaire-Vaginal symptoms (ICIQ-VS). 51/59 patients completed both questionnaires. The average age of the study population was 63years (range 39-87years). The mean BMI was 28.5 (range 20-40). 86% (n=138/159) had a previous hysterectomy. 98% (n=156/159) of patients did not have any intraoperative complications. 0.62% (n=1/159) had a bladder injury. Mesh exposure was noted in 4% of the entire group (n=6/135) at follow-up with overall reoperation rate of 9% (n=13/135). Statistically significant improvement in most arms of the ICIQ-VS questionnaire was noted in the cohort of 51 patients at follow-up. Our data revealed a very low intraoperative complication rate with a mesh exposure rate of 4%. The prospective study showed a statistically significant improvement in vaginal symptoms.