De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair

OBJECTIVE: We sought to determine the rate of de novo stress incontinence, pelvic muscle symptoms, mesh exposure, visceral injury rate, and recurrent prolapse after transvaginal mesh repair. STUDY DESIGN: We conducted a retrospective review of 335 consecutive women with stage II or worse vaginal prolapse who underwent Prolift (Ethicon, Somerville, NJ) between July 7, 2005 and Jan. 31, 2008. RESULTS: In all, 71% underwent total Prolift, 20% anterior, and 8% posterior alone. Average age was 62 years and mean follow-up was 8 months. The intraoperative visceral injury rate was 6.6%, mesh expo-sure rate was 3.8%, and recurrent failure rate was 5.2%. The postoperative de novo stress incontinence rate was 24.3%. In this series, 18% of women had pelvic muscle symptoms postoperatively; 74% of these resolved within 6 months with conservative management. CONCLUSION: After Prolift, surgeons can expect a low rate of recurrent prolapse and mesh exposure. However, pelvic muscle dysfunction and de novo stress incontinence will be encountered postoperatively in a moderate number of women.