Korean J Urol.  2008 Aug;49(8):739-744.

The Clinical Experience of Genital Pelvic OrganProlapse with the Prolift(TM) System

• Han JY
• Lee KS
• Choo MS

Abstract

PURPOSE: In the surgical treatment of pelvic organ prolapse(POP), treatment failure and re-operation rates are relatively high when conventional mesh-free surgical methods are employed. Recently, a transvaginal prolapse repair method using surgical mesh has come into broad usage. The principal objective of this study was to report on the clinical efficacy and safety of transvaginal mesh repair of genital prolapses using the Prolift(TM) system.
MATERIALS AND METHODS
We included 31(mean age 61.1 years) patients who had undergone pelvic organ prolapsed treatment with the Prolift(TM) system. The evaluation included a medical history, physical examination including Pelvic Organ Prolapse staging system(POP-Q), a urodynamic study, and a Pelvic Floor Distress Inventory(PFDI). An anatomic cure after intervention was defined as stage 0 and an improvement was defined as stage I. Anatomic failures were defined as stage II or higher. The patients were monitored at 4, 12 and 52 weeks postoperatively, and the mean follow-up period was 13.7 months.
RESULTS
Preoperative anterior vaginal wall prolapse to the POP-Q was stage II in 13, III in 14, IV in 4, uterine or vaginal vault prolapse stage II in 3, III in 6, IV in 1 and posterior vaginal wall prolapse stage II in 3, and stage III in 7. Anterior, posterior and total repair were performed in 21(67.8%), 1(3.2%), and 9(29.0%) patients, respectively. 90.3%(28/31) of the patients had been anatomically cured upon follow-up examination, and 93.5%(29/31) reported being satisfied with the result of the operation. Pre-and postoperative urinary symptoms, as well as prolapse symptoms as evaluated by PFDI, were improved significantly.
CONCLUSIONS
Pelvic floor surgery using the Prolift(TM) system appears to be both effective and safe.

Keyword

Prolapse; Surgical mesh; Surgical procedure

MeSH Terms

Follow-Up Studies
Humans
Pelvic Floor
Pelvic Organ Prolapse
Physical Examination
Prolapse
Surgical Mesh
Treatment Failure
Urodynamics

Figure

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  Fig. 1 Total prosthetic implant. 1: anterior part, 2: intermediate part, 3: posterior part.

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  Fig. 2 Skin incision site. (1) For the placement of the strap of the anterior segment, a second cutaneous incision was made 1cm lateral and 2cm below the preceding incision at the posterolateral edge of the obturator foramen. (2) For the positioning of the posterior segment in the ischioanal fosssa, a 4mm cutaneous incision was made approximately 3cm lateral and 3cm down from the anus.

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  Fig. 3 Mesh implant placement. The transvaginal mesh positioned in the areas of the vesicovaginal and rectovaginal dissection spaces (All contents copyright at Int Urogynecol J 2006;17:315-20).

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