There were no statistically significant differences between the two groups in terms of the patients’ background information, such as age, BMI, parity number, history of total hysterectomy, and pelvic organ prolapse quantification (POP-Q) stage.
There were significant differences found in terms of the concomitant procedure required with the transvaginal anterior wall mesh implantation. These were as follows: posterior colporrhaphy (L group: 74.2%; S group: 15.9%), posterior wall mesh implantation (L group: 49.3%; S group: 3.2%), and midurethral sling operations (L group: 28.0%; S group: 48.3%).
There were also significant differences found in terms of the time required for the operations. The median duration of surgery was 83 min in the L group and 46 min in the S group. The median duration of anesthesia was 111 min in the L group and 85 min in the S group (Table 1).
The overall rates of intraoperative and postoperative complications, including minor ones, were 11.5% in the L group and 4.5% in the S group, indicating a significant difference between the groups.
Among complications, minor and major injuries to adjacent organs (e.g., the bladder, ureter, and rectum) showed a significant difference (L group: 5.9%; S group: 0.2%). Among procedures causing the injuries, stripping the vaginal wall did not show a significant difference (L group: 0.8%; S group: 0.2%). However, the puncture procedure for anchoring points showed a significant difference (L group: 5.0%; S group: 0.0%). There was no significant difference in blood transfusions, pelvic pain requiring analgesia for more than one month, postoperative de novo dyspareunia, or subcutaneous abscesses; all occurred in less than 0.3% of either group. Postoperative total mesh removal was not performed in any case in either group.
The incidence rate of vaginal wall mesh extrusion, which was reported to be high by a previous study , was 2.8% in the L group and 0.9% in the S group—low in both groups, but significantly lower in the current small-mesh TVM group. Although the anatomical recurrence rate, which is defined as the lowest point of the prolapse reaching the hymen, was 11.5% in the L group and 4.5% in the S group, indicating a significant difference, the symptomatic recurrence rate did not show a significant difference between the groups (L group: 2.8%; S group: 1.7%) (Table 2).