Safety and Effectiveness of Transvaginal Mesh Placement in Treating Pelvic Organ Prolapse

Abstract Objective To observe the clinical effect and complications of transvaginal mesh (TVM) placement on treating pelvic organ prolapse (POP). Methods From May 2014 to June 2017, 89 patients with moderate to severe pelvic organ prolapse and pelvic floor defect (PFD) had received TVM pelvic reconstruction at our hospital. The operation time, intraoperative blood loss and intraoperative complications of all patients were recorded, and the incidence of postoperative complications was also observed. In addition, the POP-Q was utilized to evaluate the severity of POP in patients before surgery, as well as at 6 weeks, 6 months, 12 months and 24 months after surgery, respectively; besides, the Pelvic Floor Influence Questionnaire-7 (PFIQ-7), Pelvic Floor Dysfunction Inventory 20 (PFDI-20), and Patient Global Impression of Improvement (PGI-I) were adopted to evaluate the quality of life of patients. Results All the 89 cases had successfully completed the surgery, with the operation time of 60.0 ± 13.0 min and the intraoperative blood loss of 57.2 ± 21.9 mL. All patients had no bladder or rectal injury during the surgery. 2 patients displayed asymptomatic recurrence ,10 cases had postoperative fever, while 3 had mesh exposure, and all of them were improved after symptomatic treatment. Upon discharge, the lumbosacral and pubic discomfort, as well as pelvic organ dragging sensation had disappeared in all patients. In the final follow-up, the PFIQ-7 and PFDI-20 scores in the 89 cases were reduced compared with those before surgery ( P s < 0.05). Conclusions TVM placement is effective on treating moderate to severe POP, which is associated with a lower complication rate and higher postoperative satisfaction.