[ANCHORLESS VAGINAL IMPLANT FOR THE TREATMENT OF ADVANCED PELVIC ORGAN PROLAPSE].

Introduction: The use of vaginal mesh in pelvic surgery has previously demonstrated anatomical advantage combined with surgical complications that have called its effectiveness into question.

Objectives: To evaluate the safety and efficacy of an anchorless implant for the repair of pelvic organ prolapse (POP) in women with risk factors for recurrence.

Methods: Retrospective evaluation of the self-retaining support (SRS) implant in women with a ≥2 degree vaginal anterior and apical prolapse with an increased risk of prolapse recurrence. Demographic and clinical data were collected, and women suspected of recurrence, based on a telephone questionnaire, were re-examined.

Results: Sixty women were evaluated. Four (6.6%) underwent reoperation due to prolapse recurrence of the posterior and vaginal apex. No intra-operative complications were documented; 4 (6.6%) women had surgical field hematoma treated conservatively. No chronic pelvic pain or dyspareunia were documented. Six (10%) women who reported bulging sensation in the telephone questionnaire were examined and found to have prolapse of the posterior compartment and not of the anterior or apical compartment treated by the SRS.

Conclusions: Use of the SRS demonstrated 93.3% success rate at a mean follow-up of 14 months postoperatively without intra-operative complications and mild post-op complications at follow-up.

Discussion: Short term data on the use of the SRS demonstrate that anchorless mesh technique may preserve the benefits of vaginal mesh while eliminating surgical complications. The SRS is a safe and effective surgical alternative for the repair of anterior and apical vaginal prolapse in women with advanced pelvic organ prolapse and risk factors for relapse.