One-year dynamic MRI follow-up after vaginal mesh repair: evaluation of clinical, radiological, and quality-of-life results

Background Pelvic organ prolapse (POP) is a common disorder in elderly women often surgically repaired with alloplastic meshes; yet knowledge of the pelvic floor behavior and multi-compartment defects postoperatively is scarce. Purpose To evaluate the 1-year outcome after mesh repair in patients wit...

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Bibliographic Details
Published in:Acta radiologica (1987) 2015-08, Vol.56 (8), p.1002-1008
Main Authors: Brocker, Kerstin A, Alt, Celine D, Rzepka, Jakub, Sohn, Christof, Hallscheidt, Peter
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis of variance
Assessments
Defects
Dynamic tests
Dynamics
Female
Follow-Up Studies
Germany
Humans
Longitudinal Studies
Magnetic Resonance Imaging
Middle Aged
Patient Satisfaction
Pelvic Organ Prolapse - diagnosis
Pelvic Organ Prolapse - psychology
Pelvic Organ Prolapse - surgery
Quality of Life - psychology
Repair
Surgery
Surgical Mesh
Surveys
Treatment Outcome
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Summary:Background Pelvic organ prolapse (POP) is a common disorder in elderly women often surgically repaired with alloplastic meshes; yet knowledge of the pelvic floor behavior and multi-compartment defects postoperatively is scarce. Purpose To evaluate the 1-year outcome after mesh repair in patients with POP using clinical examination (CE), dynamic magnetic resonance imaging (dMRI), and the prolapse quality-of-life (P-QOL) questionnaire. Material and Methods A prospective observational study was conducted of 69 women undergoing pelvic mesh surgery. Clinical examination, dMRI, and the P-QOL questionnaire were applied before and after surgery to evaluate POP. Mean outcome measures were POP outcome as determined on clinical and dMRI examinations and its impact on quality of life. Statistical results were obtained with SPSS version 15.0. ANOVA was used to compare pre-/postsurgical quality of life data. Results Sixty-nine women (mean age, 64.75 years; BMI, 26.75 kg/m2; postmenopausal, 89.2%) were recruited and treated with Seratom® or Perigee™ mesh implants. A significant improvement in the position of bladder neck, vaginal vault/uterus, pouch of Douglas, and rectum was found 12 weeks and 1 year after surgery using POP-Q scale and dMRI. Advanced cystoceles and enteroceles seem underestimated by CE using the POP-Q system compared to dMRI results (P = 0.003 and P 
ISSN:0284-1851
1600-0455
DOI:10.1177/0284185114544241