Hong Kong Med J 2013;19:511–7 | Number 6, December 2013 | Epub 20 Jun 2013
Tension-free vaginal mesh for the treatment of pelvic organ prolapse in Chinese women
HL Fan, Symphorosa SC Chan, Rachel YK Cheung, Tony KH Chung
Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
OBJECTIVE. To assess perioperative and short-term outcomes after tension-free vaginal mesh repair of pelvic organ prolapse in local Chinese women.
DESIGN. Case series.
SETTING. The urogynaecology unit of a university teaching hospital in Hong Kong.
PATIENTS. All women with stage III or more pelvic organ prolapse who underwent tension-free vaginal mesh repair with or without vaginal hysterectomy from May 2007 to June 2011.
MAIN OUTCOME MEASURES. Perioperative and short-term outcomes.
RESULTS. In all, 47 women underwent the procedure during the study period. The mean operating time was 94 minutes, the mean estimated blood loss was 163 mL, and the mean hospital stay was 4 days. Four patients had visceral injuries, all of which were identified and repaired during the operation; all four patients recovered uneventfully. The mean duration of follow-up was 25 (standard deviation, 13) months. Pelvic organ prolapse quantification improved significantly; nine (19%) of the patients had recurrent stage II prolapse but only one was symptomatic, six (13%) had postoperative mesh exposure, three of whom underwent mesh excision. There were five (11%) who had de-novo urodynamic stress incontinence, which was mostly mild and managed conservatively. Overall 91% (43/47) were satisfied with their operative outcome.
CONCLUSIONS. The success rate of tension-free vaginal mesh repair for the treatment of pelvic organ prolapse in local Chinese women was comparable to rates reported internationally. There was a high degree of subjective satisfaction with the procedure. There were low rates of mesh exposure and de-novo stress incontinence that was mostly asymptomatic or mild.
Key words: Pelvic organ prolapse; Surgical mesh; Treatment outcome; Urinary incontinence, stress
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