Tension-free Polypropylene Mesh-related Surgical Repair for Pelvic Organ Prolapse has a Good Anatomic Success Rate but a High Risk of Complications

Background： Food and Drug Administration announcements have highlighted the standard rate of mesh-related complications. We aimed to report the short-term results and complications of tension-free polypropylene mesh （PROSIMATM） surgical repair of pelvic organ prolapse （POP） using the standard category （C）, timing （T）, and site （S） classification system. Methods： A prospective cohort study of 48 patients who underwent PROS1MATM mesh kit-related surgical repairs were followed for two years at Peking Union Medical College Hospital. Recurrence was defined as symptomatic POP quantification （POP-Q） Stage II or higher （leading edge ≥ -1 cm）. The Patient Global Impression of Change Questionnaire, the Chinese version of the Pelvic Floor Impact Questionnaire short-form-7 and POP/Urinary Incontinence Sexual Questionnaire short-form- 12 were used to evaluate the self-perception and sexual function of each patient. Mesh-related complications conformed to the International Urogynecological Association/International Continence Society joint terminology. The paired-sample t-test, one-way analysis of variance, Fisher＇s exact test, Kaplan-Meier survival analysis and log-rank test were used to analyze data. Results： All patients were followed up for ≥12 months; 30 （62.5%） patients completed the 24 months study. We observed a 93.8% （45/48） positive anatomical outcome rate at 12 months and 90.0% （27/30） at 24 months. Recurrence most frequently involved the anterior compartment （P 〈 0.05）. Pelvic symptoms improved significantly from baseline （P 〈 0.05）, although the patients＇ impressions of change and sexual function were not satisfying. Vaginal complication was the main complication observed （35.4%, 17/48）. The survival analysis did not identify any relationship between vaginal complication and anatomical recurrent prolapse （POP-Q 〉 Stage II） （P = 0.653）. Conclusions： Tension-free polypropylene mesh （PROSIMA^TM）-related surgical repair of POP has better short-term anatomical outcomes at the apical and posterior compartments, but a low patient satisfaction rate. The mesh complications were not the definitive cause of recurrence.