Mid-term results of pelvic organ prolapse repair using a transvaginal mesh: the experience in Sherbooke, Quebec
Bibliographic record
Abstract
Objective: The objective was to report our experience on theimplantation of the Prolift system since 2005.Methods: Fifty-six patients were operated on between July 2005and August 2008 by 1 surgeon. The patients were implanted withthe transvaginal mesh, the Prolift system, for the treatment of recurrentor high-grade (Baden-Walker stage III or IV) multiple compartmentpelvic organ prolapse (POP) associated with symptoms.A concomitant anti-incontinence surgery was performed in 38patients (68%).Results: The population had a mean age of 68 (range 46-88), abody mass index of 27 (range 21-40) and a parity average of 3(range 1-16). Previous POP repair had been performed in 17 patients(30%) and a hysterectomy in 43 (77%). The operating room timewas on average 98 minutes (range 70-135), blood loss 81 mL(range 50-300) and hospital stay 3 days (range 1-10). With a medianfollow-up of 21 months, we found that the cure rate for POP was91% (48/53) and the reoperation rate was 8% (4/53). Perioperativecomplications included 1 rectal laceration and 1 prolonged bleeding.Short-term postoperative complications included 10 episodesof transient urinary retention that required immediate tape releasein 4 patients. Long-term complications included 5 POP recurrences,2 low grade and 3 high grade.Conclusion: The Prolift system appears to be a relatively safe andeffective alternative to conventional surgeries for the treatment ofrecurrent or high-grade multiple compartment POP, because of ahigh mid-term cure rate and a satisfactory complication profile.However, long-term follow-up is still needed to confirm these results.Objectif : Notre objectif ici est de parler de notre expérience avecl’implantation du système Prolift depuis 2005.Méthodologie : Entre juillet 2005 et août 2008, 56 patientes ontété opérées par le même chirurgien. Les patientes ont subi uneimplantation du système de bandelette transvaginale Prolift, pourle traitement d’un prolapsus pelvien pluricompartimental récurrentou de grade élevé (stade III ou IV de Baden-Walker) associéà des symptômes. Une chirurgie anti-incontinence concomitantea été réalisée chez 38 patientes (68 %).Résultats : L’âge moyen de la population de l’étude était de 68 ans(entre 46 et 88 ans), l’indice de masse corporelle moyen était de27 (entre 21 et 40), et en moyenne, la parité était de 3 (entre 1 et16). Une intervention antérieure de correction d’un prolapsus pelvienavait été effectuée chez 17 patientes (30 %), et une hystérectomie,chez 43 patientes (77 %). En moyenne, la durée de l’interventionétait de 98 minutes (de 70 à 135), la perte sanguine, de 81 mL (de50 à 300) et la durée du séjour à l’hôpital, de 3 jours (de 1 à 10).Après un suivi médian de 21 mois, le taux de guérison observépour le prolapsus pelvien était de 91 % (48/53) et le taux de répétitionde l’opération était de 8 % (4/53). (Trois patientes perdues ausuivi ne sont pas incluses dans le taux de guérison.) Les complicationspériopératoires incluent une lacération rectale et un épisodede saignement prolongé. Les complications postopératoires à courtterme incluent 10 épisodes de rétention urinaire transitoire nécessitantun retrait immédiat de la bandelette chez 4 patientes. Lescomplications à long terme incluent 5 récidives du prolapsus pelvien,2 de faible grade et 3 de grade élevé.Conclusion : Le système Prolift semble être une solution de rechangerelativement sûre et efficace aux interventions traditionnelles pourle traitement du prolapsus pelvien pluricompartimental récurrentou de grade élevé, en raison d’un taux élevé de guérison à moyenterme et d’un profil de complications acceptable. Cependant, unsuivi à long terme est toujours requis pour valider ces résultats.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".