Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complications
Abstract Introduction To evaluate patient‐reported outcomes and clinical findings after surgery for apical prolapse with the transvaginal Uphold mesh technique. Moreover, to evaluate the rate of mesh‐related complications. Material and Methods A historical cohort study of patients who underwent surg...
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Wiley
2022-06-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14322 |
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| author | Anne Munch Susanne Greisen Susanne Maigaard Axelsen Karl Møller Bek Marianne Glavind‐Kristensen |
| author_facet | Anne Munch Susanne Greisen Susanne Maigaard Axelsen Karl Møller Bek Marianne Glavind‐Kristensen |
| author_sort | Anne Munch |
| collection | DOAJ |
| description | Abstract Introduction To evaluate patient‐reported outcomes and clinical findings after surgery for apical prolapse with the transvaginal Uphold mesh technique. Moreover, to evaluate the rate of mesh‐related complications. Material and Methods A historical cohort study of patients who underwent surgery from January 1, 2012 to April 30, 2019, at Aarhus University Hospital, Denmark. Pelvic examination and patient completion of questionnaires were performed in 2018–2019. Information on adverse events and reoperations was obtained from medical records. Results A total of 240 patients were operated on using the Uphold mesh, 89% due to recurrent prolapse. Follow‐up was attended by 192 patients (80%). Median follow‐up time was 30 months, interquartile range 19–52. During follow‐up, 29 patients (15%) underwent reoperation due to prolapse and are considered failures. Among the remaining, patient satisfaction was high. Thus, average score for pelvic symptoms affecting daily life was 2, on a scale of 0–10, where 0 represents no symptoms. The Patient Global Impression of Improvement (PGI‐I) had an average score of 6.4 (1: very much worse; 7 very much better). Preoperatively, 89.5% of the women had grade 2 or more apical prolapse, whereas at follow‐up, this was only 6.1%. Perioperative heavy bleeding needing embolization was observed in one patient (0.5%). Two patients had serious constriction of the ureter and needed re‐operation. Postoperative complications, primarily temporary voiding problems, were observed in 15 patients (8%). Complications during the follow‐up period were registered in 23 patients (12%); eight of these were mesh erosions. Due to complications, 11 patients (6%) needed re‐operation. Conclusions The study confirms that the Uphold procedure in a centralized set‐up is a procedure with high patient‐reported satisfaction even in a population characterized by a high proportion of recurrent prolapse. Moreover, the procedure seems safe with acceptable complication rates. |
| format | Article |
| id | doaj-art-75d15c62c44f475bbbbadf66fd91dbe5 |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-75d15c62c44f475bbbbadf66fd91dbe52025-08-20T02:09:25ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-06-01101658959610.1111/aogs.14322Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complicationsAnne Munch0Susanne Greisen1Susanne Maigaard Axelsen2Karl Møller Bek3Marianne Glavind‐Kristensen4Department of Obstetrics and Gynecology Aarhus University Hospital Aarhus DenmarkDepartment of Obstetrics and Gynecology Horsens Regional Hospital Aarhus DenmarkDepartment of Obstetrics and Gynecology Aarhus University Hospital Aarhus DenmarkDepartment of Obstetrics and Gynecology Aarhus University Hospital Aarhus DenmarkDepartment of Obstetrics and Gynecology Aarhus University Hospital Aarhus DenmarkAbstract Introduction To evaluate patient‐reported outcomes and clinical findings after surgery for apical prolapse with the transvaginal Uphold mesh technique. Moreover, to evaluate the rate of mesh‐related complications. Material and Methods A historical cohort study of patients who underwent surgery from January 1, 2012 to April 30, 2019, at Aarhus University Hospital, Denmark. Pelvic examination and patient completion of questionnaires were performed in 2018–2019. Information on adverse events and reoperations was obtained from medical records. Results A total of 240 patients were operated on using the Uphold mesh, 89% due to recurrent prolapse. Follow‐up was attended by 192 patients (80%). Median follow‐up time was 30 months, interquartile range 19–52. During follow‐up, 29 patients (15%) underwent reoperation due to prolapse and are considered failures. Among the remaining, patient satisfaction was high. Thus, average score for pelvic symptoms affecting daily life was 2, on a scale of 0–10, where 0 represents no symptoms. The Patient Global Impression of Improvement (PGI‐I) had an average score of 6.4 (1: very much worse; 7 very much better). Preoperatively, 89.5% of the women had grade 2 or more apical prolapse, whereas at follow‐up, this was only 6.1%. Perioperative heavy bleeding needing embolization was observed in one patient (0.5%). Two patients had serious constriction of the ureter and needed re‐operation. Postoperative complications, primarily temporary voiding problems, were observed in 15 patients (8%). Complications during the follow‐up period were registered in 23 patients (12%); eight of these were mesh erosions. Due to complications, 11 patients (6%) needed re‐operation. Conclusions The study confirms that the Uphold procedure in a centralized set‐up is a procedure with high patient‐reported satisfaction even in a population characterized by a high proportion of recurrent prolapse. Moreover, the procedure seems safe with acceptable complication rates.https://doi.org/10.1111/aogs.14322apical compartmentcomplicationspatient‐reported outcomespelvic organ prolapserecurrent prolapsetransvaginal mesh |
| spellingShingle | Anne Munch Susanne Greisen Susanne Maigaard Axelsen Karl Møller Bek Marianne Glavind‐Kristensen Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complications Acta Obstetricia et Gynecologica Scandinavica apical compartment complications patient‐reported outcomes pelvic organ prolapse recurrent prolapse transvaginal mesh |
| title | Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complications |
| title_full | Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complications |
| title_fullStr | Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complications |
| title_full_unstemmed | Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complications |
| title_short | Treatment of apical vaginal prolapse with minimal mesh repair (Uphold): patient‐reported long‐term outcomes and mesh‐related complications |
| title_sort | treatment of apical vaginal prolapse with minimal mesh repair uphold patient reported long term outcomes and mesh related complications |
| topic | apical compartment complications patient‐reported outcomes pelvic organ prolapse recurrent prolapse transvaginal mesh |
| url | https://doi.org/10.1111/aogs.14322 |
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