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Eur J Obstet Gynecol Reprod Biol. 2019 Jan;232:33-39. doi: 10.1016/j.ejogrb.2018.10.009. Epub 2018 Oct 6.

Long-term (8.5 years) analysis of the type and rate of reoperation after transvaginal mesh repair (Prolift®) in 349 patients.

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CHRU Jeanne de Flandre, Lille, France. Electronic address:
CHRU Jeanne de Flandre, Lille, France.
Department of Biostatistics, Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France. Electronic address:
FMH en Gynécologie et Obstétrique Hôpital du Valais, Sion, Switzerland. Electronic address:
Department of Obstetrics and Gynecology, University of Liège, CHR La Citadelle, Boulevard du 12e de Ligne, n°1, 4000, Liège, Belgium.
CHRU Jeanne de Flandre, Lille, France. Electronic address:



Polypropylene meshes have specific complications, and in 2016 the Food and Drug Administration required a Premarket Approval for their use in pelvic prolapse repair, as there was a lack of long-term data. Our objectives were to determine the long-term reoperation rates and type in our patients after transvaginal mesh repair and to study their risk factors.


We were able to follow up with 349 patients from a single University Hospital, with phone calls, after a median time of 8,5 years. The 8.5-year reoperation rates were derived from Kaplan-Meier survival curves.


Our global, long-term reoperation rate, including mesh complications, prolapse recurrence and urinary incontinence after a median follow-up of 8.5 years, was 14.5%. The mesh-related complication rate (including mesh exposures, infections, and retractions requiring surgery) was 4.3%, the urinary incontinence rate was 5.7%. The prolapse recurrence rate was 7.2%; mainly found with posterior mesh only (18.5% of reoperations). For total Prolift, the reoperation rate for prolapse recurrence was only 4%. Moreover, 867% of the patients who had an anterior Prolift only or a posterior Prolift only and who were re-operated for prolapse recurrence showed recurrence exclusively in another compartment. In bivariate analysis, only the posterior mesh type was significantly associated with prolapse recurrence versus total meshes.


Despite their market withdrawal, the transvaginal meshes are a safe and efficient option for pelvic organ prolapse surgical management. Low rates of mesh complications can be achieved with cautious dissection and adequate training of surgeons.


Exposure; Mesh; POP (pelvic organ prolapse); Prolift; Recurrence

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