Authors and affiliations:                                                                                                                                                
Vikiela Galica1
; Daniele Castellani1; Pietro Saldutto1;  Daniela Biferi1; Giovanni Giovanditti1; Cristian Cicconetti1; Giuseppe Paradiso Galatioto1; Carlo Vicentini.
1 Department of Health Science, University of L'Aquila, Teramo Hospital, Italy

Topic: Pelvic organ prolapse surgery.
To evaluate the effectiveness and safety on medium-term of transvaginal Anterior Elevate® mesh kit system (AES) in women with symptomatic stage 3 or 4 anterior and/or apical pelvic organ prolapse (POP).                                                                                                        
Materials and Methods.
This is a retrospective, monocentric study enrolling 56 women experiencing symptomatic anterior vaginal prolapse with or without apical descent (POP-Q stage 3 or 4). All women received an AES implantation. Primary endpoint was anatomic correction of prolapse; success was defined as POP-Q stage ≤1 or asymptomatic stage 2. Secondary endpoints were quality-of-life (QOL) results and patient safety outcomes, which were assessed by 3 validated self-reporting questionnaires at baseline and annually: International Consultation on Incontinence questionnaire on urinary incontinence (ICIQ-UI) short form, International Consultation on Incontinence questionnaire on vaginal symptoms (ICIQ-VS) and  prolapse-quality of life questionnaire (P-QOL).                                                                                                               
Mean operative time was 47.3 (± 8) minutes. There was no bladder and rectal injuries. Vaginal mesh exposure was present in 3 (5,3%) patients. Very good anatomical outcomes were seen, with one (1,8%) failure at 6-months, 4 (7,1%) at 1-year, 6 at 2-years (10,7%). Statistically significant improvements were seen in the ICIQ-VS and P-QOL questionnaires throughout follow-up.                                                                                                                                        
AES is an attractive minimally-invasive transvaginal procedure with good evidence related to mid-term safety and efficacy.

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