Evaluation of the single-incision Elevate system to treat pelvic organ prolapse: follow-up from 15 to 45 months

Int Urogynecol J. 2015 Sep;26(9):1341-6. doi: 10.1007/s00192-015-2693-x. Epub 2015 Apr 30.

Abstract

Introduction and hypothesis: The aim of this study was to assess the 2-year clinical outcomes of pelvic reconstructive surgery with the single-incision Elevate system (American Medical Systems, Minnetonka, MN, USA).

Methods: This retrospective study was conducted from November 2010 to August 2013, and included 210 patients with pelvic organ prolapse stage 3 or 4 who underwent pelvic reconstructive surgery with an Elevate system and were followed for 1 to 3 years postoperatively. Assessments included pre- and postoperative Pelvic Organ Prolapse Quantification (POP-Q) stage, Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7) and multi-channel urodynamic examinations. Anatomical success was defined as postoperative POP-Q stage 0 or I.

Results: The anatomical success rates were 95 % for the anterior vaginal wall, 99 % for the posterior vaginal wall and 94 % for the apical vaginal wall after a median 27 months of follow-up. POP-Q, UDI-6 and IIQ-7 scores, maximal flow rate and post-voiding residual urine all improved significantly after surgery. Complications included 1 case of internal bleeding, 4 cases of mesh exposure, 5 cases of recurrent prolapse that required salvage operations, and 3 cases of urine retention that required intermittent catheterization. There were no bladder or bowel injuries during surgery.

Conclusions: Pelvic reconstructive surgery with the Elevate system yielded good anatomical outcomes and symptom improvement after 2 years of follow-up.

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures / instrumentation*
  • Gynecologic Surgical Procedures / statistics & numerical data
  • Humans
  • Middle Aged
  • Pelvic Organ Prolapse / surgery*
  • Recurrence
  • Retrospective Studies