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Patients With Mesh Exposure Maintain High Cure Rate of Pelvic Organ Prolapse: Presented at AUGS By Laura Gater CHICAGO -- September 9, 2008 -- Patients with vaginal exposure of mesh after pelvic organ prolapse surgery maintain a high rate of anatomic cure and improvement in quality of life, according to research presented here at the American Urogynecologic Society 29th Annual Scientific Meeting (AUGS). James C. Lukban, DO, Division of Gynecologic Specialties and Obstetrics, Eastern Virginia Medical School, Norfolk, Virginia, presented the study findings on September 6. Nonabsorbable, synthetic mesh has anatomic durability that has been confirmed by numerous clinical studies, according to Dr. Lukban. The mesh's characteristics are that it is durable, elastic, and resistant; it enables good tissue integration with minimal inflammatory response. However, it is also known to be associated with vaginal extrusion. To determine the rate of extrusion associated with type I polypropylene mesh kits in women with pelvic organ prolapse (POP), Dr. Lukban and colleagues pooled data from 2 ongoing, prospective trials that evaluate the efficacy and safety of the mesh systems for pelvic organ prolapse repair. They enrolled 262 women undergoing surgical repair of prolapse in the anterior (AC), posterior (PC), and/or apical compartments; 174 women received AC placement with the Perigee mesh kit, while 195 had PC placement with or without apical or uterine descent with the Apogee mesh kit. The mesh kits that were used in the study required minimal dissection for placement, tension-free preservation, and normal visceral function, noted Dr. Lukban. The rate of extrusion was 6.8% in AC and 13.8% in PC. Each trial's primary outcome was to determine the rate of anatomic cure, and secondary outcome was incidence of extrusion. Women were followed postoperatively at 6 weeks, 3 months, 6 months, and 12 months. Follow-up will continue through 2 years after surgery. Of the mesh implants in the AC, 5% required surgical repair, as did 7% of implants in the PC, stated Dr. Lukban. Anatomic cure for patients with extrusion was 91.7% for AC, 88% for posterior (92% apical) at mean follow-up of 13.9 months (range 6.0-22.9) in the AC group and 12.6 months (range 5.1-23.8) in the PC group. [Presentation title: Incidence of Extrusion in Patients Treated With Type I Polypropylene Mesh "KITS" in Pelvic Organ Prolapse Repair. Paper 78] E-mail this page to a friend or colleague! To print, use this version