Lightweight transvaginal mesh is associated with lower mesh exposure rates than heavyweight mesh

There has been a scarcity of long-term published data comparing lightweight versus heavier weight transvaginal mesh for prolapse repair. The aim was to ascertain the long-term rates of recurrent prolapse and mesh exposure in a cohort of vaginal repairs utilizing two different weights of transvaginal mesh. Data were prospectively collected on all mesh-augmented vaginal prolapse repairs performed with Apogee® or Perigee® mesh kits (IntePro® or IntePro Lite®) at a single centre over an 11-year period, with patients receiving ongoing annual follow-up. A sequential stepwise univariate and multivariate Cox regression analysis was performed to identify variables that were significantly associated with mesh exposure. Eighty-eight women with 113 mesh kits were reviewed from the original cohort of 158 women. The median length of follow-up was 6.4 years (range 1.1–12.5 years). Mesh exposure rate per implant in the IntePro® group was 16/40 (40%) versus 4/73 (5.5%) in the IntePro Lite® group (p < 0.0001). A hazard ratio of 4.2 was identified for mesh exposure for IntePro® versus IntePro Lite® (95% CI 3.0–6.8). There was no difference in rates of recurrent prolapse between the heavy- and lightweight mesh groups. Lightweight transvaginal mesh is associated with lower mesh exposure rates than heavyweight mesh at a median follow-up of 6.4 years, with no difference in rates of recurrent prolapse.