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Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 5-year prospective follow-up study

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Abstract

Introduction and hypothesis

To evaluate clinical effectiveness and complication rates at 5 years following the total Trans Vaginal Mesh (TVM) technique to treat pelvic organ prolapse.

Methods

Prospective, observational, multi-centre study in patients with prolapse of stage II or higher.

Results

Of the 90 women enrolled in the study, 82 (91 %) were available for the 5-year follow-up period. At the 5-year endpoint, success, defined as no surgical prolapse reintervention and leading edge <−1 (International Continence Society [ICS] criteria) or above the level of the hymen, was 79 % and 87 % respectively. A composite criterion of success defined as: leading edge above the hymen (<0) and no bulge symptoms and no reintervention for prolapse was met by 90 %, 88 % and 84 % at the 1-, 3-, and 5-year endpoints respectively. Quality of life improvement was sustained over the 5 years. Over the 5-year follow-up period, a total of only 4 patients (5 %) required re-intervention for prolapse, while a total of 14 patients (16 %) experienced mesh exposure for which 8 resections needed to be performed. Seven exposures were still ongoing at the 5-year endpoint, all asymptomatic. Only 33 out of 61 (54 %) sexually active patients at baseline remained so at 5 years. De novo dyspareunia was reported by 10 %, but no new cases at the 5-year endpoint. One patient reported de novo unprovoked mild pelvic pain at 5 years, 5 reported pains during pelvic examination only.

Conclusions

Five-year results indicated that TVM provided a stable anatomical repair. Improvements in QOL and associated improvements in prolapse-specific symptoms were sustained. Minimal new morbidity emerged between the 1- and 5-year follow-up.

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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

SUI:

Stress urinary incontinence

TVM:

Transvaginal mesh

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Source of financial support

Ethicon.

Conflicts of interest

Bernard Jacquetin holds the patent for Prolift® for which he receives royalties from Ethicon. B. Jacquetin, P. Debodinance, C. Rosenthal and M. Cosson have all held consultancy positions for Ethicon. B. Jacquetin, H. Clavé, M. Cosson and P. Debodinance have all accepted payment of travel expenses or honoraria from Ethicon. M. Cosson and P. Debodinance have all had acceptance of payment for research. P. Hinoul and J. Gauld are employed by Ethicon. D. Salet-Lizée, R. Villet, J. Berrocal, B. Fatton and O. Garbin: no financial disclosures regarding Ethicon.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Estaing University Hospital, Clermont-Ferrand, France

    B. Jacquetin & B. Fatton

  2. Medical Affairs, Ethicon, Somerville, USA

    P. Hinoul

  3. Clinical Development, Ethicon, Livingston, UK

    J. Gauld

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

    C. Rosenthal

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

    H. Clavé

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

    O. Garbin

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

    J. Berrocal

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

    R. Villet & D. Salet-Lizée

  9. Department of Obstetrics and Gynaecology, General Hospital Dunkerque, Dunkirk, France

    P. Debodinance

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

    M. Cosson

  11. Department of Obstetrics-Gynaecology-Human Reproduction, Estaing University Hospital, 1 place Lucie Aubrac, 63003, Clermont Ferrand Cedex 1, France

    B. Jacquetin

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  1. B. Jacquetin
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  2. P. Hinoul
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  3. J. Gauld
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  4. B. Fatton
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  5. C. Rosenthal
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  6. H. Clavé
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  8. J. Berrocal
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  9. R. Villet
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  10. D. Salet-Lizée
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  11. P. Debodinance
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  12. M. Cosson
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Corresponding author

Correspondence to B. Jacquetin.

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Jacquetin, B., Hinoul, P., Gauld, J. et al. Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 5-year prospective follow-up study. Int Urogynecol J 24, 1679–1686 (2013). https://doi.org/10.1007/s00192-013-2080-4

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  • DOI: https://doi.org/10.1007/s00192-013-2080-4

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