AI Article Synopsis
- The study focuses on the management of complications arising from the use of commercial prolapse mesh kits, highlighting the experiences with transvaginal and perineal approaches.
- A retrospective review conducted from 2006 to 2010 involved 23 patients, revealing common complications such as pain and mesh exposure, with a median onset of problems occurring 10 months post-surgery.
- The results indicate that transvaginal mesh removal is generally safe and effective, leading to symptom resolution, while the new ICS/IUGA classification system enhances the reporting and understanding of these complications.
Article Abstract
Purpose: Commercial prolapse mesh kits are increasingly used in the management of pelvic organ prolapse. We present our experience with the transvaginal/perineal management of synthetic mesh related complications from prolapse kits. In addition, we used the new ICS/IUGA (International Continence Society/International Urogynecological Association) prostheses/grafts complication classification system to report on our contemporary series.
Materials And Methods: A retrospective chart review of all patients who underwent surgical removal of transvaginal mesh for mesh related complications after prolapse kit use from November 2006 to April 2010 at 1 institution was performed. We report our contemporary series of mesh complications using the new ICS/IUGA prostheses/grafts complication classification system. Postoperative pain, degree of improvement and presence of continued symptoms were reported by patients at last followup.
Results: A total of 23 patients underwent transvaginal removal of mesh during the study period. Mean patient age was 61 years. Median period of latency to mesh related complication was 10 months (range 1 to 27). Indications for mesh removal included vaginal/pelvic pain (39%), dyspareunia (39%), vaginal mesh extrusion/exposure (26%), urinary incontinence (35%), recurrent pelvic organ prolapse (22%), bladder mesh perforation with recurrent urinary tract infection (22%), rectal mesh perforation (4%), ureteral perforation injury (4%), retained foreign body (surgical sponge) in the bladder (4%) and vesicovaginal fistula (9%), with most patients citing more than 1 reason.
Conclusions: Although technically difficult in some cases, purely transvaginal mesh excision appears to be safe with resolution of almost all presenting symptoms. Although slightly cumbersome, the new ICS/IUGA prostheses/graft complication classification system can be used to report and more accurately characterize mesh complications.
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| http://dx.doi.org/10.1016/j.juro.2011.12.066 | DOI Listing |
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