Anterior-Apical transvaginal Mesh (Surelift) for Advanced Urogenital Prolapse: Surgical and Functional Outcomes at 1 Year.

To determine the objective and subjective outcomes of pelvic organ prolapse (POP) using modified SureLIFT®, and to evaluate surgical complications and post-operative impact on quality of life (QOL) and lower urinary tract symptoms (LUTS).

Retrospective cohort study SETTING: Tertiary-care university hospital PATIENTS: Patients with symptomatic anterior or apical pelvic organ prolapse of stage III and above INTERVENTIONS: All patients underwent pelvic reconstructive surgery with modified SureLIFT® transvaginal mesh kit.

83 women who underwent pelvic reconstructive surgery with modified SureLIFT® for symptomatic anterior or apical prolapse of stage III and above between April 2018 to January 2019 were reviewed retrospectively. All completed 72-hour voiding diary, urodynamic study and multiple validated quality-of-life (QOL) questionnaires at baseline and between 6 to 12-month postoperatively. Descriptive statistics were used for demographics and perioperative data. Paired- samples t test and McNemar's test were applied for comparison of pre- and post-operative continuous and categorical data respectively. Primary outcomes were the objective cure of POP, defined as anterior and apical prolapse of POP-Q stage ≤ 1, and subjective cure based on negative answers to POPDI-6 (Pelvic Organ Prolapse Distress Inventory 6). The objective and subjective cure at 1-year was 97.6% and 92.8% respectively. There were significant improvements in QOL scores post-operatively. Whilst bladder outlet obstruction improved, de novo USI (urodynamic stress incontinence) and SUI (stress urinary incontinence) were increased at 18.9% and 21.6% respectively at 1-year follow-up. Mesh extrusion rate was 4.8%.

Modified SureLIFT® has good objective and subjective cure rates at 1-year post-operatively with 4.8% mesh extrusion rate. There was significant improvement in LUTS and QOL. De novo USI at 6 to 12 months was increased but not sufficiently bothersome to warrant surgery.

Journal of minimally invasive gynecology. 2020 May 13 [Epub ahead of print]

Tsia-Shu Lo, Kai Lyn Ng, Ting-Xuan Huang, Yi-Pin Chen, Yi-Hao Lin, Wu-Chiao Hsieh

Division of Urogynaecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Medical Center, Taipei, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China. Electronic address: ., Department of Obstetrics & Gynaecology, National University Hospital of Singapore, Singapore., Division of Urogynaecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China., Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China., Division of Urogynaecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China.