⊕⊕ Low a,d *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; MD: Mean difference; I-QOL: Incontinence Quality of Life; RCT: Randomised controlled trial; RR: Risk ratio; UI: Urinary incontinence. GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. a Downgraded for study limitations (-1): high risk of bias. b Downgraded for imprecision (-1): no events in small study. c Downgraded for imprecision (-1): confidence interval includes both no effect and appreciable benefit; low numbers of events. d Downgraded for imprecision (-1): confidence interval includes no effect and both appreciable benefit and appreciable harm; low numbers of events. 5 Transurethral radiofrequency collagen denaturation for the treatment of women with urinary incontinence (Review)
In this large cohort of patients with mesh removed for a diverse array of complications, cultures of the explanted vaginal mesh demonstrate frequent low-density bacterial colonization. We found no differences in culture results from women with delayed-onset pain versus acute pain, vaginal mesh extrusions versus no extrusions, or recurrent UTIs using standard culture methods. Chronic prosthetic infections in other areas of medicine are associated with bacterial biofilms, which are resistant to typical culture techniques. Further studies using culture-independent methods are needed to investigate the potential role of chronic bacterial infections in delayed vaginal mesh complications.
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