Long-term occurrence of secondary compartment pelvic organ prolapse after open mesh sacrocolpopexy for symptomatic prolapse

Aims: To report on the long-term occurrence of secondary compartment pelvic organ prolapse (POP) after open mesh sacrocolpopexy (MSC). Methods: A prospectively maintained, IRB-approved database of non-neurogenic women with symptomatic triple compartment POP who underwent open MSC between 1999 and 2011 and had a 1-year minimum follow-up was reviewed. Length of follow-up was categorized as: intermediate (1-3 yr), late (3-5 yr), and very late (>5 yr). Demographic data, history of POP repairs, exam with Baden-Walker grading, validated questionnaires (Urogenital Distress Inventory short form [UDI-6], QoL), and outcomes at each follow-up visit were recorded. Failure was defined by either secondary compartment prolapse recurrence (BW > 2) on examination at the last visit or re-operation for POP. Results: Out of sixty-eight, sixty-one women met study criteria. Mean age was 66 ± 11, mean BMI 26.1 ± 4.5, mean parity 2.8 ± 1.4 and cohort was mostly Caucasian. ­­Eighty seven percent had prior hysterectomy and 72% had prior POP repair. Mean follow-up was 6.8 ± 3.9 years with over 75% in the late or very late categories. There were 4/61 (7%) clinical failures, 3 of which underwent surgical repair (2 anterior and 1 posterior compartment repair) at 2-12 year interval post-MSC. Mean changes between baseline and last visit UDI-6, QoL, and BW prolapse grade trended favorably. Conclusions: Following open MSC, the rate of secondary prolapse compartment failure was found low at very long-term follow-up.