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Transvaginal Mesh Placement For Prolapse: QOL Improved


 

Major Finding: Quality of life and sexual health measures significantly improved in women who underwent transvaginal mesh placement for prolapse.

Data Source: A retrospective study of 99 women.

Disclosures: None reported.

HOLLYWOOD, FLA. — Significant improvements in quality of life and sexual health measures were reported 1 year after women underwent transvaginal mesh placement for prolapse in a retrospective study.

Clinicians reported an 87% cure rate among the 99 women compared with baseline, based on a score of 2 or less on the Pelvic Organ Prolapse Quantification (POP-Q) examination.

Dr. Stephanie Molden, an ob.gyn. in Allentown, Pa., and her associates found significant subjective improvements in quality of life (QOL) and sexual health at 1 year compared with baseline on multiple measures, including the Pelvic Floor Distress Inventory–20 (PFDI-20), the Pelvic Floor Impact Questionnaire–Short Form 7 (PFIQ-7), and the Organ Prolapse/Urinary Incontinence Sexual Questionnaire–12 (PISQ-12).

There were significant increases in all components of the PFDI-20 and the PFIQ-7, regardless of which vaginal compartment was treated.

“Interestingly, we did not see any statistically significant shortening of the vaginal length like in previous studies,” said Dr. Miles Murphy, a study coauthor who presented the findings at the annual meeting of the American Urogynecologic Society.

Each participant had pelvic reconstruction using transvaginal mesh (Gynecare ProLift plus M system, Ethicon Inc.).

At follow-up, 87 of the 99 patients had completed the PFDI-20 and the PFIQ-7, 73 had POP-Q examinations, and 22 had completed the PISQ-12.

“There were significant improvements in quality of life and anatomic parameters,” said Dr. Murphy, also an ob.gyn. in Allentown.

For example, mean PDFI-20 scores at baseline were 79 vs. 26 at follow-up 1 year later. Mean PFIQ-7 scores were 64 at baseline and decreased to 12 at 1 year. Both of these instruments are scored 0 (best) to 300 (worst). In addition, PISQ-12 scores increased from a mean of 84 at baseline to 94 at follow-up. The PISQ-12 is scored from 0 (worst) to 124 (best).

“No erosions were seen over this 1 year,” he said in response to a meeting attendee's question.

Another meeting attendee asked if other factors might have also improved outcomes and confounded the data.

“These procedures are obviously not the only factor,” Dr. Murphy replied. For example, a patient may have had a posterior repair done at the same time as anterior mesh placement.

“The point is these are the types of procedures we are doing, so this reflects reality.”

Dr. Murphy added, “Prospective, randomized trials are still needed.”

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