Drs. Moore and Miklos of Atlanta Urogynecology Associates Publish the 1st Article in Worldwide Literature on a New Generation Mesh Procedure for Pelvic Organ Prolapse

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International Laparoscopic, Urogynecologic and Aesthetics Reconstructive Vaginal Surgeons, Dr. Moore and Dr. Miklos Continue to Break New Ground Within the Field of Urogynecology.

Dr. Robert D. Moore and Dr. John R. Miklos, world leaders in the field of graft use in vaginal and pelvic reconstructive surgery, recently published in the International Urogynecology Journal, the first article in the worldwide literature regarding the use of the Anterior Elevate system which is known as a second-generation mesh procedure for pelvic organ prolapse. Pelvic organ prolapse is a condition that affects women where the pelvic organs such as the bladder or uterus descends and causes symptoms such as pain, pressure, hernia type symptoms, urinary incontinence or other bowel and/or bladder symptoms. Per Dr. Moore and Miklos’ study, approximately 250,000 women a year have surgery for these problems. Mesh use in pelvic surgery has become more common secondary to the fact that using native tissue in the repair has a very high failure rate. Vaginal mesh use has shown in many surgical trials superior cure rates compared to native tissue repairs. Recently, however, mesh placed vaginally has been under scrutiny secondary to complications such as mesh extrusion through the vaginal wall, bladder injuries, and other problems being reported. The FDA released a safety notification regarding these reports of complications in July of 2011 and recently held hearings regarding the use of some of the mesh kits on the market and did call for more research to be completed on these type of procedures. Most of the complications reported to the FDA were in regards to "first generation" mesh kits that passed needles through the groins and/or buttock cheeks to fixate mesh arms to the pelvic floor muscles to help hold the graft in place.

The Anterior Elevate system is a second-generation vaginal mesh procedure that utilizes only a single vaginal incision to place the mesh under the bladder and also support the top of the vagina without having to pass needles blindly through the groins or the buttocks. It utilizes a new generation lighter weight mesh and very small self-fixating tips that hold the mesh graft in place. It was designed to address some of the complications that were being reported with the first generation procedures but also maintain the advantages of using a graft to help support the bladder and the vagina and obtain much higher cure rates compared to when the patients native tissue is used. Dr. Moore has been principal investigator on several multicenter trials evaluating the use of mesh in prolapse and incontinence in the past. In the current trial, Dr. Moore and Miklos report on 60 women that underwent the Anterior Elevate procedure that had an average follow-up of over one year, with some patients being more than 2 years out from surgery. The reported cure rate, as published in their article, was over 90%. No patients required re-operation for pain, failure or mesh complications. With the newer lighter-weight mesh, no vaginal extrusions or erosions were reported. Dr. Moore and Dr. Miklos are also involved in 2 other ongoing prospective multi-center trials that will continue to follow patients and monitor them utilizing this procedure.

Dr. Miklos and Dr. Moore of Atlanta Urogynecology Associates, continue to share their experiences and knowledge with their peers, to ensure that the quality of patient care is not lost with the advancements in surgical techniques. Their dedication to their patients is why they are known as Master Surgeons. Drs. Miklos and Moore will be in Hollywood, Florida in November as invited faculty to lecture at the 40th Annual AAGL Global Congress on Minimally Invasive Gynecology. They both will address at the Urogynecology postgraduate courses, as well as presenting 6 new scientific research studies.

Pub Med Abstract: http://www.ncbi.nlm.nih.gov/pubmed/21866442

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John R. Miklos, MD

Robert D. Moore, DO
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