Does trocar-guided tension-free vaginal mesh (Prolift™) repair provoke prolapse of the unaffected compartments?

The objective of this study was to assess the effect of the tension-free vaginal mesh (Prolift (TM)) procedure on the non-treated and initially unaffected vaginal compartments. This prospective observational cohort study involved 150 patients who underwent a Prolift (TM) procedure. Pelvic organ prolapse (POP) quantification and evaluation of prolapse symptoms with validated questionnaires was performed pre-operatively and 6 and 12 months postoperatively. Primary outcome was the rate of POP stage a parts per thousand yenII in the non-treated vaginal compartments. Twenty-three percent of all patients developed a de novo POP stage a parts per thousand yenII in the untreated compartment. This occurred in 46% and 25% of patients after an isolated anterior and isolated posterior Prolift (TM), respectively. Tension-free vaginal mesh treatment of one vaginal compartment seems to provoke the development of vaginal prolapse in initially unaffected vaginal compartments, particularly after an isolated anterior Prolift (TM) procedure.