Transvaginal Polytetrafluoroethylene Mesh Surgery for Pelvic Organ Prolapse: One-Year Safety and Efficacy Results

Abstract

ObjectivesTo evaluate the efficacy and safety of the polytetrafluoroethylene (PTFE) mesh by comparing conventionally used polypropylene (PP) mesh in tension-free vaginal mesh (TVM) surgery for pelvic organ prolapse (POP). MethodsWe conducted an observational cohort study of patients who underwent TVM using a PTFE or PP mesh. PTFE was used from June 2019 to May 2021, and PP mesh from January 2018 to May 2019. Outcomes included POP recurrence, perioperative complications, and patient satisfaction. Restricted mean survival time (RMST) was used to analyze POP recurrence, comparing the time to recurrence between the two groups at 1 year after TVM. ResultsOf 171 patients, 104 underwent PP mesh placement (PP group) and 67 underwent PTFE mesh placement (PTFE group). POP recurrence was observed in 10 and nine patients in the PP and PTFE groups, respectively. The mean time until the recurrence in the PTFE group was significantly shorter than that in the PP group (RMST difference: -20.3 days; 95% CI, -40.1 to -0.5; P=0.044). Subgroup analysis revealed the mean time until recurrence was significantly shorter in the PTFE group for postoperative periods 3 months or less, ages >70 yrs, and POP stage ≥3. There were no intervention cases in either group and no significant differences in the perioperative complications. Patient satisfaction was greater in the PTFE group after three months postoperatively. ConclusionTVM surgery with a PTFE mesh is more prone to recurrence than that with a PP mesh, but with higher patient satisfaction. Within three months of surgery, elderly patients and those with advanced stage POP require care to prevent recurrence.