The pelvic organ prolapse (POP) is a pathology that can affect almost the 50% of patients with history of vaginal delivery, and has a great impact in their quality of life. 

Conservative treatment focuses in the strengthening of pelvic muscles. Surgical treatment can be with an abdominal approach or vaginal approach, with or without the use of meshes.

Vaginal meshes are mostly synthetic prosthesis of non-absorbable material with a reconstructive objective of the pelvic floor anatomy. The use of meshes in POP treatment has been controversial in last years in terms of safety, due to the great number of postoperative complications reported, such as extrusions, pelvic pain or dyspareunia. There are different types of meshes regarding the material, the type of anterior and posterior anchorage and number of arms. Meshes without needles seem to be the less harmful and have better results in terms of safety.  

The aim of this study is to evaluate the use of vaginal mesh without needles in our centre, according to the results and safety of vaginal mesh surgical technique.

Descriptive study of data regarding patients undergoing surgical treatment of POP using vaginal mesh without needles (MIPS®), from January 2013 until December 2017 (n=21). 

Following data was collected from patients: age and BMI, type and staging of POP, early and late postoperative complications (extrusion, vesical lesion, voiding dysfunction, hematoma, constipation or obstructive defecation, de novo urgency, pelvic pain) and results (considering cure or improvement of their POP when result was stage 2 POP asymptomatic), with at least 1 year follow-up.

The average age of the group was 60. According to their BMI, 47.6% (10) had < or =25, and 52.4% (11) had BMI>25. 

Regarding type of prolapse, most of the patients (80.9%, n=17) presented anterior prolapse, 3 patients presented posterior prolapse and only 1 presented superior or central prolapse. The majority of the patients [90.5%(19)] presented prolapse stage 3 or greater. 

77.8% of patients presenting anterior and central prolapse were classified as cured from their POP. All posterior prolapses were cured with meshes. 

Regarding postoperative complications, there were only 3 patients presenting complications in early postoperative period (first 3 months after surgery), 1 presented voiding dysfunction, 1 presented vaginal hematoma and the other one presented deterioration of previous urgency. 7 patients presented late postoperative complications (more than 3 months after surgery), with 28.6%(2) presenting extrusion,  28.6%(2) recurrence of POP, 14.3%(1) faecal incontinence, and 14.3%(1) de novo urgency. No patient with sexual activity referred dyspareunia.

The average age of the group matches with the peak of incidence of this pathology in general population.

Overweight does not predominate in our group of study, which has been recognised as a risk factor for pelvic floor pathology. 

We can report from results that exists a good percentage of cure in our group of study, as only 4 patients were classified as not cured, and only 1 of them required new POP surgery. 

Postoperative complications were more frequent in late postoperative period. Extrusion and recurrence of POP were the more frequently presented, only presented in less than 30% of cases. Evaluating patients with complications, we found out that 2 of the patients presenting early complications also presented late complications. None major complication was referred

Although use of synthetic meshes in vaginal surgery is controversial, and despite our limited experience in this surgery, the results in terms of cure are encouraging. A greater sample and follow up of patients might be useful in detecting and evaluating postoperative complications.