Hypothesis / aims of study
To evaluate the long-term safety, efficacy, patient satisfaction, and prognostic factors of transvaginal partially absorbable minimesh (SERATOM®) for pelvic organ prolapse (POP) repair with up to 10-year follow-up.
Study design, materials and methods
Retrospective cohort study of 274 women (from 300 consecutive; 26 excluded for missing data) who underwent SERATOM® minimesh repair for Stage ≥II POP (July 2013–February 2015). Preoperative demographics, POP-Q measurements, and symptoms were recorded. Short-term (4-month POP-Q) and long-term (mean 9.8±0.2 years) follow-up assessed anatomical outcomes, symptom resolution, mesh complications, reoperations, and satisfaction. McNemar tests compared pre- versus long-term symptoms. Multivariate logistic regression identified independent prognostic factors.
Results
Mean age was 62.1±9.6 years; 63.5% had multi-compartment prolapse. Mean operative time was 29.5±7.1 minutes. Short-term anatomical success was 95.2% (259/272). All POP-Q points improved significantly (all P<0.001). No mesh erosions occurred at 10-year follow-up. SUI decreased from 40.4% to 4.8% (P<0.001); OAB from 33.1% to 7.4% (P<0.001); defecation disorders from 8.8% to 1.5% (P<0.001). POP-specific reoperation occurred in 9.1%, independently predicted by prior pelvic surgery (OR 2.63, P=0.045) and posterior mesh placement (OR 2.44, P=0.038). Long-term dyspareunia (5.5%) was predicted by prior hysterectomy (OR 6.33, P=0.005) and preoperative dyspareunia (OR 5.64, P=0.010). Satisfaction was 89.0%±17.6%.
Interpretation of results
Short-term anatomical success at 4 months was 95.2% (259/272). All POP-Q measurement points improved significantly, and analyses demonstrated significant long-term symptom resolution. On multivariate logistic regression, prior pelvic surgery (OR 2.63, 95% CI 1.02–6.76; P=0.045) and posterior mesh placement (OR 2.44, 95% CI 1.05–5.67; P=0.038) independently predicted POP-specific reoperation. Multi-compartment prolapse independently predicted high satisfaction. Prior pelvic surgery was inversely associated with multi-compartment prolapse (OR 0.35, 95% CI 0.18-0.67; P=0.002),