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Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 3-year prospective follow-up study

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Abstract

Introduction and hypothesis

To evaluate clinical outcomes at 3 years following total transvaginal mesh (TVM) technique to treat vaginal prolapse.

Methods

Prospective, observational study in patients with prolapse ≥stage II. Success was defined as POP-Q-stage 0-I and absence of surgical re-intervention for prolapse. Secondary outcome measures were: quality of life (QOL), prolapse-specific inventory (PSI), impact on sexual activity and complications.

Results

Ninety women underwent TVM repair, 72 a hysterectomy. Anatomical failure rate was 20.0% at 3 years. Three patients required re-intervention for prolapse. Improvements in QOL- and PSI-scores were observed at 1 and 3 years. Vaginal mesh extrusion occurred in 14.4% patients. After 3 years, 4.7% asymptomatic extrusions remained present. Of 61 sexually active women at baseline, a significant number of patients (41%) ceased sexual activity by 3 years; de novo dyspareunia was reported by 8.8%. One vesico-vaginal fistula resolved after surgery.

Conclusion

Medium-term results demonstrate that the TVM technique provides a durable prolapse repair.

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Abbreviations

BMI:

Body mass index

ICS:

International Continence Society

LOCF:

Last observation carried forward

POP:

Pelvic organ prolapse

POP-Q:

Pelvic organ prolapse quantification

PSI:

Prolapse-specific inventory

QOL:

Quality of life

SD:

Standard deviation

TVM:

Trans vaginal mesh

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Conflicts of interest

Bernard Jacquetin holds the patent for Prolift®, for which he receives royalties from Ethicon. B.Jacquetin, B. Fatton, C. Rosenthal, H. Clavé, P. Debodinance, O. Garbin, J. Berrocal, R. Villet, D. Salet Lizée and M. Cosson all have had consultancy positions for Ethicon. P. Hinoul and J. Gauld are employed by Ethicon.

Source of financial support

ETHICON Women’s Health & Urology.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Hôtel-Dieu Maternité, University Hospital of Clermont-Ferrand, Boulevard Léon Malfreyt, 63058, Clermont-Ferrand cedex 1, France

    Bernard Jacquetin & Brigitte Fatton

  2. Department of Gynaecology, Saint Germain Private Hospital, Brive La Gaillarde, France

    Claude Rosenthal

  3. Department of Gynaecology, Saint George Private Clinic, Nice, France

    Henri Clavé

  4. Department of Obstetrics and Gynaecology, General Hospital Dunkerque, Dunkerque, France

    Philippe Debodinance

  5. Medical Affairs, Ethicon-Women’s Health and Urology, Issy-les-Moulineaux, France

    Piet Hinoul

  6. Clinical Development, Ethicon-Women’s Health and Urology, Livingston, UK

    Judi Gauld

  7. Department of Obstetrics and Gynaecology, SIHCUS-CMCO University Hospital, Strasbourg, France

    Olivier Garbin

  8. Department of Gynaecology, L’Europe Private Clinic, Rouen, France

    Juan Berrocal

  9. Department of Gynaecology, Diaconesses Hospital, Paris, France

    Richard Villet & Delphine Salet Lizée

  10. Department of Obstetrics and Gynaecology, Hôpital Jeanne de Flandre, University Hospital, Lille, France

    Michel Cosson

Authors
  1. Bernard Jacquetin
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  2. Brigitte Fatton
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  3. Claude Rosenthal
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  4. Henri Clavé
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  5. Philippe Debodinance
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  8. Olivier Garbin
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  9. Juan Berrocal
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  10. Richard Villet
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  11. Delphine Salet Lizée
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  12. Michel Cosson
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Corresponding author

Correspondence to Bernard Jacquetin.

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Jacquetin, B., Fatton, B., Rosenthal, C. et al. Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 3-year prospective follow-up study. Int Urogynecol J 21, 1455–1462 (2010). https://doi.org/10.1007/s00192-010-1223-0

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  • DOI: https://doi.org/10.1007/s00192-010-1223-0

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