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Comparison between Elevate Anterior/Apical system and Perigee system in pelvic organ prolapse surgery: clinical and sonographic outcomes

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Abstract

Objective

The aim of this study was to assess the incidence of de novo stress urinary incontinence (SUI) and sonographic features of implanted transvaginal mesh in continent women treated with Elevate™ anterior/apical [single-incision mesh (SIM-A)] or Perigee™ [transvaginal mesh with sacrospinous fixation (TVM + SSF)] in extensive pelvic organ reconstruction surgery.

Methods

This prospective observational study was done from May 2010 to January 2013. Patients were recruited from two tertiary centers, and the Elevate™ and Perigee™ systems were compared. Patients who had overt or occult SUI, previous prolapse or mesh insertion were excluded.

Result

Fifty-seven patients in the SIM-A group and sixty-one in the TVM + SSF group were analysed. All completed a minimum of 1-year follow-up. Groups were demographically and statistically similar. There was a significantly high incidence of de novo SUI postoperatively in the SIM-A group. The objective and subjective cure rate of pelvic organ prolapse (POP) were comparable between groups, with incidence of mesh erosion in the SIM-A group and three in the TVM + SSF group. Sonographic evaluation showed significant increase in mesh length in the SIM-A group.

Conclusion

Elevate™ a offered lower incidence of mesh erosion and comparable results on anatomical POP correction; however, incidence of de novo SUI was high. There is an apparent lengthening of implanted Elevate® mesh sonographically.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Keelung, Keelung Medical Center, Keelung, Taiwan, Republic of China

    Tsia-Shu Lo & Pei-Ying Wu

  2. School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China

    Tsia-Shu Lo & Yi-Hao Lin

  3. Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou and Taipei Medical Center, Taoyuan, Taiwan, Republic of China

    Tsia-Shu Lo & Yi-Hao Lin

  4. Department of Obstetrics and Gynecology, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia

    Nazura bt Karim

  5. Fellow of the Division of Urogynecology, Department of Obstetrics & Gynaecology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

    Nazura bt Karim, Eileen Feliz M. Cortes & Yiap Loong Tan

  6. Department of Obstetrics & Gynecology, De La Salle University Medical Center, Dasmariñas, Cavite, Philippines

    Eileen Feliz M. Cortes

  7. Department of Obstetrics and Gynecology, Kuching General Hospital, Sarawak, Malaysia

    Yiap Loong Tan

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  1. Tsia-Shu Lo
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  2. Nazura bt Karim
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  3. Eileen Feliz M. Cortes
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  4. Pei-Ying Wu
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Correspondence to Tsia-Shu Lo.

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Lo, TS., bt Karim, N., Cortes, E.F.M. et al. Comparison between Elevate Anterior/Apical system and Perigee system in pelvic organ prolapse surgery: clinical and sonographic outcomes. Int Urogynecol J 26, 391–400 (2015). https://doi.org/10.1007/s00192-014-2492-9

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  • DOI: https://doi.org/10.1007/s00192-014-2492-9

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