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abstract

335 - SHORT-TERM OUTCOMES OF TRANSVAGINAL MINIMAL MESH REPAIR FOR PELVIC ORGAN PROLAPSE

335

SHORT-TERM OUTCOMES OF TRANSVAGINALMINIMAL MESH REPAIR FOR PELVIC ORGAN PROLAPSE

Y. CHANG1, K. HUANG2;
1Kaoshiung Chang Gung Mem. Hosp.,Kaoshiung, Taiwan, 2Kaohsiung Chang Gung Mem. Hosp.,Kaohsiung, Taiwan.

Introduction: To assess thesafety and short-term clinical outcomes of transvaginal pelvic floorreconstruction with Uphold Vaginal Support System.
Objective:We enrolled 101 women with pelvic organ prolapse ProlapseQuantification (POP-Q) stage 2 or higher, who received transvaginalpelvic floor reconstruction with Uphold mesh procedure from Jan.2015to Sep.2016 in our hospital.
Methods: Anatomical outcomewas assessed by the POP-Q system. We compared the preoperative andpostoperative results of urodynamic study in 59 patients (58.4%) whocompleted the examination. Postoperative complications were alsorecorded.
Results: Among the 101 cases, 16 patients (15.8%)underwent concurrent transvaginal hysterectomy, 8 (7.9%) had priorhysterectomy history, and the uterus was preserved in 77 patients(82.8%). The mean blood loss during operation was 59.2ml, the meanoperation time was 92 minutes, and the mean hospitalization stay was5.2 days. We assessed POP-Q in 98% cases before and after thesurgery. Postoperative POP-Q improved significantly. Urodynamicstudies were completed in 59 patients pre- and 6 monthspostoperatively. Postoperative urodynamic studies showed improvedbladder outlet obstruction (increased maximal/ average flow rate anddecreased residual urine). Postoperative complications were noted inthree cases: one had postoperative hematoma , and was re-admittedlater for antibiotic treatment due to complicated infection; one hadmesh erosion, and the other had recurrent prolapse (defined asleading point > POP-Q stage II), and was treated with transvaginalright side sacrospinous ligament suspension. It is worth noting thattransient urine retention is not uncommon after the surgery. Amongall, 16 patients (15.8%) needed intermittent catheterization program(ICP) or Foley catheter replacement for urine retention during theirhospitalization. Two patients had Foley catheter indwelled whiledischarge.
Conclusions: The results of our study showedthat Uphold Vaginal Support System is a safe and feasible way fortransvaginal pelvic floor reconstruction with low complication rate,especially for those patients who wish to preserve theiruterus.
References: Evaluation of the single-incisionElevate system to treat pelvic organ prolapse: follow-up from 15 to45 months; Int Urogynecol J. 2015 Sep;26(9):1341-6.Minimal meshrepair for apical and anterior prolapse: initial anatomical andsubjective outcomes; Int Urogynecol J (2012)23:1753-1761.Utero-vaginal suspension using bilateral vaginalanterior sacrospinous fixation with mesh: intermediate results of acohort study; Int Urogynecol J (2015) 26:1803-1807.