Introduction

The aim of our study was to assess the long-term efficacy, the outcomes, and the complications in patients treated for pelvic organ prolapse (POP) with transvaginal anterior colporrhaphy alone (AC), AC and reinforcement by porcine Xenograft (Pelvisoft®) (AC-P), and AC and reinforcement by polypropylene mesh (AC-M).

Methods

A retrospective analisis of a prospectively maintained database of women undergoing cystocele repair between 2000 and 2015 was performed. In a cohort of 123 women, the follow-up was completed in 109: 42 patients underwent AC, 19 AC-P, and 48 AC-M. Mean follow-up was 94.80 ± 51.72 months. Subjectives outcomes have been evaluated by validated questionnaires. The personal patient satisfaction rate was also measured by the questions “are you satisfied with the surgical procedure?” and “would you confirm the same surgical choice at the time of the counseling before surgery?”. Objective outcomes have been evaluated considering a failure an anterior vaginal wall recurrence ? II° POP-Q and 2° Baden-Walker Halfway System.

Results

In all the surgical techniques used the results of PGI-I questionnaire showed a general perceived benefit of treatment as well as the results of PPBC questionnaire indicated an improvement from the previous bladder condition. The personal patient’s satisfaction rate was higher in the AC-P group. In all groups most of the interviewed women would confirm the same surgical choice. _x000D_ We find anatomical success rate > 80% in all groups with no statistically significant difference. Data showed a higher rate of complications in the AC-M group (p<0.05). _x000D_ Table 1 summarizes the characteristics of the patients, outcomes and complications. The larger number of complications in AC-M group (p<0.05) could explain the lower subjective satisfaction of patients.

Conclusions

Considering the recent FDA order to reclassify surgical mesh to class III, and the recent SCENHIR document on “Safety of surgical meshes used in urogynecological surgery” our data show in the AC group good results in a very long follow-up. The additional support given by a mesh, or a xenograft, does not increase with statistically significance the anatomic cure rate. Rather, the use of prosthetic devices leads more complications rate.

Funding

none