Outcomes and patient satisfaction after pelvic organ prolapse surgery with and without mesh: a retrospective cohort study with prospective follow-up

TL;DR

This study compares patient satisfaction and complications after three types of pelvic organ prolapse surgery, finding high satisfaction across all methods with some differences in mesh-related complications.

Contribution

The study provides a long-term comparison of patient satisfaction and complication rates for three POP surgical approaches with prospective follow-up.

Findings

All three surgical groups reported high patient satisfaction with no significant difference in overall satisfaction.

Mesh erosions occurred more frequently in transvaginal mesh repair compared to sacrocolpopexy.

Adverse events like pain and recurrence impacted patient satisfaction.

Abstract

This retrospective cohort study with prospective follow-up evaluates patient satisfaction and complication rates following pelvic organ prolapse (POP) surgery, comparing three surgical approaches: transvaginal native tissue repair, transvaginal mesh repair, and laparoscopic sacrocolpopexy.

Long-term satisfaction and postoperative complications of patients who underwent POP surgery between 2014 and 2021 at the University Women’s Hospital of Ulm were assessed via structured telephone interviews. Patient satisfaction was evaluated using the validated Freiburg Index of Patient Satisfaction (FIPS) questionnaire.

Of 782 patients with POP surgery, 297 patients with primary surgeries at our clinic were included in the analysis. Patients of all three groups were highly satisfied according to FIPS with no significant difference (p = 0.058). Complication rate also did not differ significantly between the groups except for mesh erosions with 12.9% for transvaginal mesh repair and 2.0% for sacrocolpopexy (p = 0.027). Adverse events as pain, voiding difficulty, overactive bladder (OAB), and recurrence of POP requiring operative treatment had a significant impact on the satisfaction rate of patients.

Patients of all three surgical approaches reported high satisfaction following POP surgery. Complication rate did not differ significantly except for mesh erosions. However, mesh erosions did not significantly impact patient satisfaction.

The trial was registered in the German Clinical Trials Register (DRKS00031971) on 1 June 2023.

Figures