Pelvic organ prolapse repair with a trocarless mesh system: two-year results

Introduction and hypothesis: Our aim was to investigate the efficacy of the EndoFast Reliant™ system, which is a novel trocarless mesh technology for the treatment of pelvic organ prolapse (POP). Methods: This was a retrospective cohort study including 31 female patients with POP who underwent vaginal repair. Total follow-up duration was 24 months. All patients were evaluated with a clinical history, POP-Q measures, pelvic ultrasound, body mass index (BMI), questionnaires on symptoms, and quality of life scoring system. Results: The mean age was 53 ± 9.7 years, and the mean BMI was 28.5 ± 3.9 kg/m2. The BMI of 20 patients was < 30 kg/m2. No intraoperative complications occurred. Prolapse was anatomically resolved in 87.1% of patients at 2-year follow-up. Four patients presented stage 1 non-symptomatic prolapse recurrence. De novo stress urinary incontinence developed in four (12.9%) cases and de novo urgency developed in two (6.4%) cases; all were diagnosed and treated easily with oral medication. One case of mesh exposure was found and treated conservatively. There was no migration of fasteners or mesh. Urinary retention, postoperative groin pain, and dyspareunia were not observed. Conclusions: The EndoFast Reliant™ system was found successful with high success rates, short learning time and very low complication rates in our study. However, further prospective studies with higher patient numbers and longer follow-up durations are needed to reach definitive conclusions.