Department of Urology, Hokusuikai Kinen Hospital, Ibaraki, Japan.
Department of Urology, Eastern Oomiya Medical Center, Saitama, Japan.
J Obstet Gynaecol. 2022 Aug;42(6):2115-2120. doi: 10.1080/01443615.2022.2033184. Epub 2022 Feb 15.
We investigated the frequency of further surgery post-artificial mesh (Prolift) repair of pelvic organ prolapse. In total, 257 patients who underwent Prolift repair were evaluated for further surgery frequency, clinical outcomes, and demographic characteristics. Thirty-eight (14.7%) patients underwent further surgery (median time to reoperation, 9.5 months; range, 6-22 months). Six (2.3%) patients underwent prolapse repair at a different (5 patients, 1.9%) or same site (1 patient, 0.3%). One underwent posterior Prolift repair; four, laparoscopic sacrocolpopexy; and one, vaginal hysterectomy. Eight (3.1%) underwent surgery for complications; seven (2.7%) required further surgery for mesh exposure (median, 8 months) and one (0.3%) required further surgery for mesh infection (1 month). Twenty-four (9.3%) received further surgery for stress urinary incontinence (median, 8.5 months). Despite the low frequency of further surgery post-Prolift repair, mesh-related complications should be considered. Careful long-term follow-up is necessary.Impact Statement It is widely known that vaginal mesh is used as treatment for pelvic organ prolapse (POP). Vaginal mesh is one of the treatment options for POP. However, it received a bad reputation following reports of complications associated with its use, leading to discontinuation of vaginal mesh in many countries. The findings of this study show that few patients who received Prolift repair required further surgery. The surgeries included surgery for non-POP-related conditions; subsequent surgery for stress urinary incontinence (SUI); surgery for complications including mesh exposure and infection; primary prolapse surgery for a different site and repeat surgery; and a repeat operation for prolapse arising from the same site. Based on the outcome of this study, transvaginal Prolift mesh repair is a reasonably safe and effective treatment for POP. Despite withdrawal of all mesh products from the market as instructed by the FDA, this study suggested the need to re-evaluate the role of vaginal mesh as a treatment option for POP.
我们研究了人工网（Prolift）修复盆腔器官脱垂后再次手术的频率。共有 257 名接受 Prolift 修复的患者接受了进一步手术频率、临床结果和人口统计学特征的评估。38 名（14.7%）患者接受了进一步手术（中位再手术时间为 9.5 个月；范围 6-22 个月）。6 名（2.3%）患者在不同（5 名患者，1.9%）或相同部位（1 名患者，0.3%）进行了脱垂修复。1 名患者接受了后路 Prolift 修复，4 名患者接受了腹腔镜骶骨阴道固定术，1 名患者接受了阴道子宫切除术。8 名（3.1%）患者因并发症进行了手术；7 名（2.7%）因网片暴露（中位时间 8 个月）需要进一步手术，1 名（0.3%）因网片感染（1 个月）需要进一步手术。24 名（9.3%）因压力性尿失禁（中位时间 8.5 个月）接受了进一步手术。尽管 Prolift 修复后再次手术的频率较低，但仍应考虑网片相关并发症。需要仔细的长期随访。
广泛认为阴道网片用于治疗盆腔器官脱垂（POP）。阴道网片是 POP 的治疗选择之一。然而，由于与使用相关的并发症报告，阴道网片的声誉受到影响，导致许多国家停止使用阴道网片。这项研究的结果表明，接受 Prolift 修复的患者中只有少数需要进一步手术。手术包括非 POP 相关疾病的手术；随后的压力性尿失禁（SUI）手术；包括网片暴露和感染在内的并发症手术；不同部位的原发性脱垂手术和重复手术；以及相同部位的脱垂复发手术。根据这项研究的结果，经阴道 Prolift 网片修复是一种治疗 POP 的安全有效的治疗方法。尽管 FDA 要求所有网片产品撤出市场，但这项研究表明需要重新评估阴道网片作为 POP 治疗选择的作用。
