Introduction: The use of mesh kits in pelvic organ prolapse has been curtailed because of attendant complications thought related specifically to the mesh anchoring technique. Material and Methods: A retrospective analysis of vaginal prolapse objective and subjective outcome analyzing 3 Groups: transvaginal anchored mesh (Group 1), native tissue repairs (Group 2) and anchorless implant (SRS) repairs (Group 3). Results: Groups 1,2,3 included 106, 49 and 70 patients respectively. Follow-up was comparable in the groups with Group 2 patients generally older and Group 3 having a lower mean parity. Group 3 had greater preoperative Ap measurements (Group 1 = -0.62 cm, Group 2 = -0.82 cm and Group 3 = - 1.8 cm; P < 0.05) and Bp measurements (Group 1 = 0.32 cm, Group 2 = 0.79 cm and Group 3 = -1.49 cm; P < 0.05) with significantly better postoperative Aa measurements (Group 1 = -2.31 cm, Group 2 = -1.07 cm and Group 3 = -2.87 cm; P < 0.05) and Ba measurements (Group 1 = -2.08 cm, Group 2 = -0.87 cm and Group 3 = -2.81 cm ; P < 0.05). Group 3 reported a higher mean difference improvement in PFDI-20 scores (Group 1 = 15.94, Group 2 = 9.8 and Group 3 = 49.01; P < 0.05). Overall the SRS cases experienced less postoperative complications, less recurrent prolapse and less risk of revisional surgery. Conclusions: The SRS is safe and effective with improved anatomical outcome accompanied by less prolapse recurrence and improved subjective symptoms.
