Abstract
The search for an improved vaginal mesh prompted the development of a new anchorless implant. The objective was to report on outcome after 2years of a technique using a self-retaining support (SRS) implant. Patients with anterior vaginal wall prolapse, with/without apical prolapse, were recruited. Participants underwent surgical repair using the SRS device. Demographic data, pre-surgical Pelvic Organ Prolapse Quantification (POP-Q) scoring, quality of life (QoL) questionnaires (Pelvic Floor Distress Inventory Short Form 20 [PFDI-20], Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire 12 [PISQ-12]), and surgical data were collected. Patients were followed at 2weeks, 2, 6, 12, and 24months after surgery. Objective anatomical success was defined using the NIH criteria. Twenty women were recruited for the study with an average age of 62.1years and an average parity of 4.0 deliveries. Average BMI was 28. Pre-operative mean POP-Q measurements were Aa =1.40 (-1 to 3) cm, Ba =2.3 (-1 to 6) cm and C=0.4 (-7 to 6) cm. Surgical time averaged 31.2min. Estimated blood loss averaged 165ml. No intra-operative complications were observed. One case (5%) of frame erosion was documented 8months after surgery. At 2years' follow-up, mean POP-Q measurements were: Aa=-2.95 (-3 to -2) cm, Ba=-2.85 (-3 to -2) cm, and C point -6.90 (-10 to -3) cm. Seventeen (85%) patients had stage 0 and 3 patients (15%) had stage 1. No mesh erosions or chronic pelvic pain were documented at follow-up. The total PFDI score at follow-up was decreased by 92.8 points (p<0.0001). At 2years' follow-up, the SRS implant was found to be safe, showing no intra-operative or immediate post-operative complications. All women presented with POP-Q measurements of the anterior and apical compartment at normal value (Ba ≤ -2cm) and statistically significant subjective improvement.
Published Version
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