Objective: Mesh erosion is a serious and not uncommon complication in women undergoing vaginal mesh repair. We hypothesized that mesh erosion is associated with the patient's comorbidities, surgical procedures, and mesh material. The aims of this study were to identify the risk factors and optimal management for mesh erosion.
Materials And Methods: All women who underwent vaginal mesh repair from 2004 to 2014 were retrospectively reviewed. Data on patients' characteristics, presenting symptoms, treatment and outcomes were collected from their medical records.
Results: A total of 741 women underwent vaginal mesh repairs, of whom 47 had mesh erosion. The median follow-up period was 13 months (range 3-84 months). Another nine patients with mesh erosion were referred form other hospitals. Multivariate analysis revealed that concomitant hysterectomy (odds ratio 27.02, 95% confidence interval 12.35-58.82; p < 0.01) and hypertension (odds ratio 5.95, 95% confidence interval 2.43-14.49; p < 0.01) were independent risk factors for mesh erosion. Of these 56 women, 20 (36%) were successfully treated by conservative management, while 36 (64%) required subsequent surgical revision. Compared with surgery, conservative treatment was successful if the size of the erosion was smaller than 0.5 cm (p < 0.01). Six patients (17%) had recurrent erosions after primary revision, but all successfully healed after the second surgery.
Conclusion: Concomitant hysterectomy and hypertension were associated with mesh erosion. In the management of mesh erosion, conservative treatment can be tried as the first-line treatment for smaller erosions, while surgical repair for larger erosions. Recurrent erosions could happen and requires repairs several times.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.tjog.2016.02.021 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
International Urogynecology Consultation Chapter 3 Committee 1 - Pessary Management.
Int Urogynecol J
January 2025
Division of Health Services Research & Implementation Science, Southern California Permanente Medical Group, San Diego, CA, USA.
Introduction And Hypothesis: This manuscript is part of the International Urogynecological Consultation (IUC) on Pelvic Organ Prolapse (POP), Chapter 3, Committee 1 focusing on pessary management of POP.
Methods: A narrative review was conducted by an international, multi-disciplinary group of clinicians working in the field of pelvic health following a search of the literature using the MeSH terms "pelvic organ prolapse" OR "urogenital prolapse" OR "vaginal prolapse" OR "uterovaginal prolapse" AND "pessary" OR "support device" OR "intravaginal device." Relevant studies, as determined after review using the Covidence manuscript review platform, were included.
To rest or not to rest after sacral colpopexy? Dispelling an old custom in the ERAS time.
Arch Gynecol Obstet
January 2025
Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy.
Purpose: Despite the advent of the ERAS Program, recovery after urogynecological surgery is still a highly debated topic in clinical practice. The majority of gynecologic surgeons, in fact, continue to advise patients to home rest and to avoid lifting heavy objects after surgery. The aim of the present study was to verify the impact of a moderate-high physical activity and recovery after surgery on anatomical results after LSC, with a 2-year follow-up (FU).
View Article and Find Full Text PDFMid-urethral sling with proper sling tension is an effective treatment for stress urinary incontinence in women after pelvic radiotherapy: a pilot study of case series.
Front Surg
January 2025
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Background: At present, consensus on the management of female stress urinary incontinence (SUI) after pelvic radiotherapy is lacking. We aim to assess the clinical effects of mid-urethral sling (MUS) for the treatment of SUI after pelvic radiotherapy in women.
Methods: We conducted a retrospective review of the clinical database of female with SUI after pelvic radiotherapy from June 2015 to February 2022.
The Impact of Pelvic Organ Prolapse on the Long-Term Outcomes of Transobturator Tape (TOT) Procedures-A Retrospective Study.
J Clin Med
December 2024
Department of Obstetrics and Gynecology, University Hospital RWTH Aachen, 52074 Aachen, Germany.
: Transobturator tape (TOT) procedures are a widely used and effective treatment for stress urinary incontinence (SUI), but there is limited research on mesh-related complications and revision surgeries. This study aimed to evaluate the incidence of revision surgeries and mesh-related complications following TOT procedures and identify potential risk factors influencing these outcomes. : This retrospective study analyzed data from patients who underwent TOT procedures at the specialized incontinence center of University Hospital Aachen (UHA), Germany, between January 2010 and May 2023.
View Article and Find Full Text PDFIs mesh related morbidity the real thread in ventral rectopexy? Results of a retrospective international multicentre comparative analysis of biologic versus synthetic mesh.
Colorectal Dis
January 2025
Department of Visceral Surgery, University Digestive Health Care Centre Basel-Clarunis, Basel, Switzerland.
Aim: Ventral mesh rectopexy (VMR) is an established surgical treatment for rectal prolapse and outlet obstruction. In contrast to continental Europe, in the UK and US the use of synthetic mesh has been abandoned in favour of biologic mesh, due to concerns regarding mesh related morbidity. The current study investigated if either material is superior, in terms of clinical recurrence and mesh related complications.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!