PURPOSE: The Anterior ElevateTM prolapse repair system ( AES) comprises a polypropylene mesh anchored through sacrospinous ligament and obturator fascia fixation points.
We present a comprehensive evaluation of AES through 2-year comprising focus on safety, operative characteristics, anatomic, subjective, and quality of life outcomes.
MATERIALS AND METHODS: Forty-two women underwent AES repair of =stage II anterior/apical compartment prolapse, with 2 lost to follow-up. Anatomic outcomes were assessed using POPQ staging. Subjective and quality of life outcomes were assessed validated ICIQ-VS, ICIQ-FLUTS, and IIQ-7 questionnaires. Additional outcomes comprised 3-day bladder diary and cough test, with outcomes assessed at pre-operative, 6-week, and 1- and 2-year time points.
RESULTS: Mean blood loss and operative time was 93 cc (±55) and 58 minutes (±27), respectively. POPQ points Aa, Ba, and C improved from 0.9, 0.8, and -1.3 to -2.1, -2.7, and -6.1 cm, respectively in comparison of pre-operative and 2-year evaluations (p< 0.05, all comparisons). Four patients experienced anatomic recurrence, with two associated with symptomatic recurrence via ICIQ-VS assessment. Statistically significant improvements in ICIQ-VS, ICIQ-FLUTS, and IIQ-7 were seen throughout follow-up. Adverse events comprised urinary retention, vaginal exposure, and leg pain in 5, 2, and 1 patients, respectively.
CONCLUSIONS: The AES is associated with good anatomic restoration and significant improvements in validated symptom and quality of life indices through 2-year assessment. Our experience suggests AES to be a safe and effective surgical procedure in appropriately selected patients. Long-term follow-up is important given FDA warning regarding the use of surgical mesh in the repair of POP.
Written by:
Rapp DE, King AB, Rowe B, Wolters JP. Are you the author?
Virginia Commonwealth University School of Medicine; Virginia Urology Center for Incontinence and Pelvic Floor Reconstruction.
Reference: J Urol. 2013 Aug 20. pii: S0022-5347(13)05143-4.
doi: 10.1016/j.juro.2013.08.023
PubMed Abstract
PMID: 23973517
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