2025 APFPR ANNUAL REPORT HIGHLIGHTS
ACTIVITY
- The APFPR aims to monitor outcomes of women who have surgery for
Stress Urinary Incontinence (SUI) procedures and Pelvic Organ Prolapse
(POP) procedures involving mesh or other products. - Participation in the APFPR is voluntary for surgeons and hospitals,
and as of December 2025, 3.9% of women opted out of participation. - As of December 2025, 56 hospitals (33 public and 23 private) across Australia were approved to participate in the APFPR.
- The APFPR 2025 Annual Report includes data from 2,183 patients; 2,331 procedures
and 1,982 products, with 806 procedures being added to the APFPR in 2025. - Approximately 75% (1,805) of all APFPR procedures are SUI procedures;
16% (377) are POP mesh procedures, and 7% (153) are POP mesh+SUI procedures. - The average age of women participating in the APFPR was 63 years and varied by procedure. Approximately 80% of registry participants were born in Australia.
PRIMARY ( FIRST) PROCEDURES
- The majority (73%) of SUI procedures captured by the APFPR are Primary
(first) procedures and include mid-urethral slings (61%), autologous fascial slings, Burch colposuspension and bulking agent injection procedures. The most commonlyused mesh for Primary SUI procedures was Gynecare TVT exact (70%). Women reported improvement following Primary SUI procedures for 94% of mesh slings, 91% of autologous slings, 86% of Burch colposuspensions, and 74% of bulking agents. - The most common Primary POP procedures captured by the APFPR are sacrocolpopexy
with mesh (66%) and sacrohysteropexy with mesh (31%). The most common POP mesh
used in primary procedures was TiLene Light. Women reported improvement following
Primary POP procedures with mesh in 100% of procedures. - The most common Primary POP mesh+SUI procedures captured by the APFPR were Sacrocolpopexy + Mid urethral sling (58%) followed by Sacrohysteropexy + Mid urethral sling (23%). The most common Primary POP mesh+SUI products were Gynecare TVT Exact (64%) for SUI and TiLene Light (53%) for POP mesh. Women reported improvement for the Primary SUI component in nearly 100% of SUI procedures.
RECURRENCE PROCEDURES
- The most common reasons for Subsequent SUI or POP procedures are due
to recurrence of SUI and/or POP, complications resulting in mesh excision,
or other surgical complication. - For management of SUI recurrence, the most common procedure was bulking agent
injection (60%) using Bulkamid, with 80% of women reporting improvement - For management of POP recurrence, the most common procedure was sacrocolpopexy
(80%), and the most common product was TiLene Light (41%), with 98% of women
reporting improvement - For management of POP mesh+SUI recurrence, the most common procedure
was sacrocolpopexy+midurethral sling (64%), and the most common products
were Gynecare TVT Exact (53%) for SUI mesh, and TiLene Light (74%) for POP
mesh, with 100% reporting improvement for both procedures.
COMPLICATIONS REQUIRING MESH EXCISION
- A majority of women who required mesh excision following a SUI mesh procedure
presented with pain/tenderness (62%) and/or mesh exposure (61%). The most common
procedure used for mesh excision following a SUI procedure was partial excision (47%),
with 31% reporting improvement in symptoms. - The most common presenting symptoms for women who required mesh excision
following a POP mesh procedure were mesh exposure (84%) and/or pain/tenderness
(61%). The most common procedure used for mesh excision following a POP mesh
procedure was partial vaginal mesh excision, with 40% of women reporting improvement. - The most common presenting symptoms for women who required mesh excision
following a POP mesh+SUI procedure were mesh exposure (74%) and/or
pain/tenderness (52%). The most common procedure used for mesh excision following
a POP mesh+SUI procedure was mesh excision or revision. Improvement was reported
in 57% of POP component surgeries, and 40% of SUI component surgeries
CLINICAL QUALITY INDICATORS
- Process indicators measure processes of care, such as undertaking objective
assessments before surgery, and intra-operative cystoscopies. The APFPR monitors
process indicators for all primary APFPR procedures. Process indicators are generally
very high, with cystoscopy rates close to 100% over time. - Efficacy indicators measure outcomes of care, with improvement in outcomes seen over
time for both Primary SUI and Subsequent SUI Procedures. While Primary Procedures
have shown higher overall improvement rates, more substantial improvement over time
has been made with Subsequent procedures. - Adverse events overall are low, with average readmission rates of 4% and return to theatre
rates of 2.2% for Primary SUI procedures. Numbers for other procedure adverse event
rates are too low to present statistically. - Patient Reported Outcomes including the APFQ at 6 and 24 months, the EQ5D and
EQ VAS at 12 months, and the PGII at 12 months are reported for each of the six patient
cohorts, and provide a complementary perspective to clinician reported outcomes.
Response rates for the APFPR PROMs have remained stable over the last couple of
years at around 50-60%.
Please note that more detailed information is available in the 2025 APFPR Annual Report.