Surgical treatment of advanced anterior wall and apical vaginal prolapse using the anchorless self-retaining support implant: long-term follow-up

Gil Levy, Anna Padoa, Naama Marcus, Anat Beck, Zoltan Fekete, Mauro Cervigni

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction and hypothesis: Following health notification by the FDA in 2008 of serious complications with transvaginal mesh for anterior pelvic organ prolapse, there has been a return to native tissue repairs. Earlier work with a self-retaining support (SRS) implant showed a high anatomical success rate with minimal implant-related complications over a medium-term follow-up. It is proposed that post-implant complications are more a consequence of the method of mesh anchoring rather than the implant itself. Our system incorporates an ultralight mesh with a frame that provides level I, II, and III support without the need for fixation. The first long-term outcomes of SRS implantation are presented. Methods: A prospective multicenter trial was conducted using two consecutive identical protocols of the use of the SRS implant in women with symptomatic anterior compartment prolapse extending their follow-up to 36 months. Anatomical success (Pelvic Organ Prolapse Quantification stage 0 or 1 or a Ba ≤ −2) was recorded along with subjective success as defined by regular quality-of-life (PFDI-20 and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire) assessments. Results: Sixty-seven patients completed 36 months of follow-up. Mean Ba measurements improved from 3.1 (−1 to 6) cm to −2.8 (−1 to −3) cm and C point from 0.4 (−8 to 6) cm to −6.9 (−10 cm to 1) cm. accumulating to a significant anatomical success rate of 94.3%. Subjective success based on question #3 of the PFDI-20, analyzed for the index surgical compartment, reached 95.7%. Post-operative complications included 2 cases of urinary retention, 1 minor frame exposure, 1 case of delayed voiding dysfunction, and 2 cases of de novo stress urinary incontinence. Untreated pre-operative second-degree Bp measurements had increased in 27% at follow-up. Conclusion: The long-term outcome of the SRS implant shows an excellent subjective and objective success with minimal risk of complications or need for reintervention.

Original languageEnglish
Pages (from-to)3067-3075
Number of pages9
JournalInternational Urogynecology Journal
Issue number11
StatePublished - Nov 2022
Externally publishedYes

Bibliographical note

Funding Information:
We would like to thank Prof. Andrew Zbar for his support and advice in writing this manuscript.

Publisher Copyright:
© 2021, The International Urogynecological Association.


  • Pelvic organ prolapse
  • Self-retaining support implant
  • Vaginal mesh


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