AI Article Synopsis
- The study focused on vaginoscopy using Holmium:YAG and Thulium lasers to treat upper vaginal mesh exposure after mesh sacrocolpopexy.
- A review of patient records revealed that the laser treatment was effective, with most patients experiencing no further mesh exposure post-procedure.
- The technique was found to be safe, quick, and resulted in significant symptom relief, with minimal complications reported.
Article Abstract
Objective: To describe the technique of vaginoscopy with Holmium:YAG and Thulium laser treatment of upper vaginal mesh exposure after mesh sacrocolpopexy (MSC) as well as evaluate treatment efficacy.
Methods: Following IRB approval, a chart review of all patients who underwent laser treatment of upper vaginal mesh exposure during vaginoscopy at a single institution between 2013 and 2022 was performed. Demographic information, previous mesh placement history, presenting symptoms, physical examination and vaginoscopy findings, imaging, laser type and settings, operating time, complications, and follow-up including examination and office vaginoscopy findings were extracted from electronic medical records.
Results: Five patients and 6 surgical encounters were identified. All patients had a history of MSC and symptomatic mesh exposure at the vaginal apex, which was tented up and difficult to access by traditional transvaginal mesh excision. Five patients underwent vaginal mesh treatment with laser with no further vaginal mesh exposure on follow-up exam or vaginoscopy. One patient was found to have a small recurrence at 4 months and underwent a second treatment with negative findings on vaginoscopy 7.9 months post-operatively. There were no complications.
Conclusion: Vaginoscopy using a rigid cystoscope and laser treatment of upper vaginal mesh exposure using a Holmium:YAG or Thulium laser is a safe and quick method which led to definitive symptom resolution.
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| http://dx.doi.org/10.1016/j.urology.2023.02.033 | DOI Listing |
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