Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device

BJOG. 2008 Feb;115(3):391-7. doi: 10.1111/j.1471-0528.2007.01606.x.


Objectives: To describe a new surgical procedure for pelvic organ prolapse using mesh and a vaginal support device (VSD) and to report the results of surgery.

Design: A prospective observational study.

Setting: Two tertiary referral Urogynaecology practices.

Population: Ninety-five women with International Continence Society pelvic organ prolapse quantification stage 2 or more pelvic organ prolapse who underwent vaginal surgery using mesh augmentation and a VSD.

Methods: Surgery involved a vaginal approach with mesh reinforcement and placement of a VSD for 4 weeks. At 6 and 12 months, women were examined for prolapse recurrence, and visual analogue scales for satisfaction were completed. Women completed quality-of-life (QOL) questionnaires preoperatively and at 6 and 12 months.

Main outcome measures: Objective success of surgery at 6 and 12 months following surgery. Secondary outcomes were subjective success, complications, QOL outcomes and patients' satisfaction.

Results: Objective success rate was 92 and 85% at 6 and 12 months, respectively. Subjective success rate was 91 and 87% at 6 and 12 months, respectively. New prolapse in nonrepaired compartments accounted for 7 of 12 (58%) failures at 12 months. Two of 4 mesh exposures required surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 23% at 12 months. QOL scores significantly improved at 12 months compared with baseline (P < 0.0001).

Conclusion: Vaginal surgery using mesh and a VSD is an effective procedure for pelvic organ prolapse. However, further studies are required to establish the role of the surgery described in this study.

Publication types

  • Multicenter Study

MeSH terms

  • Equipment Design
  • Female
  • Gynecologic Surgical Procedures / instrumentation*
  • Humans
  • Hysterectomy, Vaginal / methods
  • Length of Stay
  • Middle Aged
  • Patient Satisfaction
  • Pessaries*
  • Prospective Studies
  • Recurrence
  • Surgical Mesh*
  • Treatment Outcome
  • Uterine Prolapse / surgery*
  • Vagina / surgery