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Outcomes of Pelvic Organ Prolapse Repair by the Vaginal Route Using Avaulta Plus® in Elderly Women

Objectives: As the population ages, a rise in Pelvic Organ Prolapse (POP) repair is expected. The aim of this study was to evaluate the efficacy and safety of POP repair by the vaginal route using a mixed polypropylene and porcine skin mesh (Avaulta Plus®) in elderly patients. Methods: Retrospective study conducted at Tenon University Hospital, Paris, France including all women who underwent POP repair using Avaulta Plus® mesh by the transobturator route for POP ≥stage II from September 2008 to December 2017. Preand postoperative POP classification, quality of life scores, and complications were evaluated. All parameters were compared between the groups (≥80-year-old vs <80-year-old). Results: Twenty-one women ≥80 years and 58 women <80 years were included. There was no difference in anatomical success rate for anterior wall prolapse (100% in <80-year-old group and 96.1% in ≥80-year-old group). No differences in postoperative complication rate (p=0.53) or mesh exposure (p=0.19) were noted. An improvement in prolapse-related quality of life (PFDI-20 score) was observed for both groups. At 3 years of follow-up, the recurrence rate was similar in both groups. Conclusions: Prolapse repair using Avaulta Plus® mesh is effective in elderly patients with similar improvements in symptoms and quality of life as in younger patients. Complication rate, including mesh exposure, does not increase with age.