The advantages for using transvaginal mesh (TVM ) in the pelvic organ prolapse surgery shorten the operation time  and have better anatomical correction.However, prolapse recurrence with surgical failure was found in certain patients who undergone transvaginal mesh with Minimal Invasive Solution ( MIPS) (Neomedic International,Terrassa, Spain) mesh for the treatment of female pelvic organ prolapse (POP). Our aim is to identify the risk factors associated with pelvic organ prolapse (POP) recurrence after transvaginal mesh (TVM) repair using Minimal Invasive Solution ( MIPS) .

This was a retrospective study with two hundred and eighteen women with symptomatic POP stage II to IV were scheduled for TVM. All subjects underwent , multichannel urodynamic studies , 1 -hour pad test ,urinalyses and pelvic examination using the POP quantification (POP-Q) staging system before and after surgery.

Seven (3.2%) of 218 women reported POP recurrence after follow-up time of 12-46 months. We performed a univariate analysis of patients’ characteristics to identify the predictors of surgical failure after TVM. There was no difference between two groups as to body mass index, POP stage, mesh type, and preoperative urinary symptoms (P>0.05). However, we found the functional urethral length < 20 mm (P=0.011),International Consultation on Incontinence Questionnaire( ICI-Q )scores >= 7 (P=0.012), and the surgical experience less than 60 cases (P=0.018) were 3 significant predictors of surgical failure. Multivariate logistic regression showed the similar results.

Severe pelvic organ prolapse accompanies stress urinary incontinence more frequently. The severity of anterior vaginal wall prolapse was correlated with urethral function as observed by urodynamic investigations. In women with POP, other intrinsic urethral factors may be more important for a coexistent Stress Urinary Incontinenence (SUI) than the stage of the vaginal descent. Urethral funneling has been shown to be anatomically associated with shortened urethras as well as with urinary incontinence in up to 97%. Patients with stress urinary incontinence have been reported to show a decrease in the MUCP which leads to a decrease in functional urethral length.During the learning curve, incorrect anchorage delivers an inadequate pelvic support, leading to the higher rate of POP recurrence.

Functional urethral length < 20 mm, ICI-Q scores >= 7, and lack of surgical experience were 3 significant predictors of failure following TVM using MIPS kit. POP recurrence after mesh repair appears to be unlikely beyond the learning curve. Urethral instability and urethral funneling might be occurred in patient with severe pelvic organ prolapse coexist with SUI due to weakening and fragile support of endopelvic fascia lead to recurrence after TVM.