Posterior Transvaginal Mesh without Concurrent Surgery: How Does It have an Effect on the Untreated Vaginal Compartment.

Background/Aims: To report objective and subjective outcomes and adverse events after placement of Elevate Posterior transvaginal mesh without concurrent surgery. Changes in non-affected anterior compartment were under special interest. Methods: A prospective study of Elevate Posterior procedure in patients with symptomatic posterior compartment prolapse. Pelvic organ prolapse (POP) quantification (POP-Q) measurements and Pelvic Floor Dysfunction Inventory -20 (PFDI-20) and POP/urinary Incontinence Sexual Questionnaire (PISQ-12) questionnaires were used. Primary outcome was the incidence of de novo anterior prolapse. Secondary outcomes were complication rate and posterior compartment objective and subjective cure. Results: A total of 111 women underwent an Elevate Posterior mesh procedure and 109 attended a control visit at 3 months. De novo anterior prolapse emerged in 3.2-15% of the women, depending on the definition. Posterior POP-Q stage was obtained in 92 (84%) women and leading edge at or above the hymen in 107 (98%) women. Bulge symptoms disappeared in 86% of the cases. One (0.9%) mesh exposure was detected. Reoperation rate was 2.8, and 3.7% patients experienced postoperative pain. PFDI-20 and PISQ-12 scores improved significantly. Conclusions: A trend of de novo prolapse formation in the non-affected vaginal compartment is observed. The Elevate Posterior method is effective in terms of both objective and subjective outcomes. According to our results, the mesh exposure rate is low. (C) 2016 S. Karger AG, Basel