[Transvaginal Prosima mesh and high uterosacral ligament suspension in the treatment of severe pelvic organ prolapsey].

OBJECTIVE: To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP).

METHODS: From July 2010 to February 2011, 70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital, General Hospital of People's Liberation Army. Clinical parameters of perioperation were collected. After 1 month and 2 - 3 months, perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane. Validated prolapse quality of life questionnaires, pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect. The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51, respectively.

RESULTS: Median operation time was (195 ± 47) min and median blood loss was (160 ± 64) ml. All the patients were followed for a mean time of 13 months (2 - 19 months). Seven cases were found with mesh exposure with less than 1 cm(2). The objective cure rate was 100%. The mean score of post-operative PFIQ-7 and PFDI-20 were both 19, which were significantly lower than those of pre-operation (P < 0.05). Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination, and the second result of ultrasound scans was 2.8 cm at 2 - 3 month, which were both shortened 2.5 cm and 3.2 cm when compared with that of original size.

CONCLUSIONS: Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication. Although mesh became shorter after 2 - 3 month, it did not affect surgery efficacy.