Comparative analysis of early adverse events of pelvic organ prolapse repair with or without transvaginal mesh using Clavien‐Dindo classification

Besser, Limor; Schwarzman, Polina; Mastrolia, Salvatore Andrea; Rotem, Reut; Leron, Elad; Yohay, David; Weintraub, Adi Y.

doi:10.1002/ijgo.12501

Cited by 12 publications

(3 citation statements)

References 30 publications

(58 reference statements)

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“…The risk-benefit profile demonstrates that transvaginal mesh has limited utility in primary surgery. 12,13 Therefore, native tissue repair has regained popularity in recent years.…”

Section: Introductionmentioning

confidence: 99%

The role of hydrodissection in native tissue repair of anterior vaginal wall defects

Schwarzman

Samueli

Shaco-Levy

et al. 2021

Aust NZ J Obst Gynaeco

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A variety of surgical techniques are available for vaginal prolapse repair, indicating a lack of consensus. A debate regarding the utility of hydrodissection for splitting the surgical plane of the vaginal wall exists. The aim of this study is to evaluate the impact of hydrodissection in anterior colporrhaphy (AC). Materials:Patients undergoing primary AC were randomly assigned to an approach with (study group) versus without (control group) hydrodissection. Five surgeons performed both techniques, and the trimmed vaginal tissue was retrieved for histological analysis. Two pathologists, blinded to the surgical approach, evaluated the presence of a loose connective tissue at the surgical dissection plane (controversially deemed 'fascia', as explained in this article). In addition, we compared the operative time, pain score and haemoglobin levels. After statistical analysis, data were presented using percentile, and statistical significance was tested using the χ 2 and Fisher's exact tests.Results: Forty-six patients underwent primary elective AC, with 23 patients in each, the study and control groups. The groups were comparable regarding age (study group 60.33 ± 11.95 years and control group 59.86 ± 12.04, P = 0.90), menopausal status (study group 17 (73.9%) and control group 15 (68.2%), P = 0.67) and other characteristics. We found no difference in sample characteristics between the two groups. Connective tissue was found in only 13.6% (n = 3) of patients after hydrodissection and in 27.3% (n = 6) of patients without hydrodissection (P = 0.46). The hydrodissection group had significantly less bleeding than the control group (ΔHB 0.66 ± 0.66 vs 1.21 ± 0.84, P = 0.05). Conclusions:After hydrodissection, less bleeding was noted without compromise the surgical planes.

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“…The risk-benefit profile demonstrates that transvaginal mesh has limited utility in primary surgery. 12,13 Therefore, native tissue repair has regained popularity in recent years.…”

Section: Introductionmentioning

confidence: 99%

The role of hydrodissection in native tissue repair of anterior vaginal wall defects

Schwarzman

Samueli

Shaco-Levy

et al. 2021

Aust NZ J Obst Gynaeco

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“…Recurrent prolapse is described to be as high as 30% with native tissue surgery, which was the reason for the implementation of synthetic meshes into vaginal surgery. Perioperatively, the incidence of complications is comparable between the native tissue surgery vs transvaginal mesh (TVM) surgery . Long‐term objective anatomical results have been reported to be superior in women with TVM compared with native tissue surgery, which might be due to the fact that both the anterior and apical compartments are supported.…”

Section: Introductionmentioning

confidence: 99%

“…Perioperatively, the incidence of complications is comparable between the native tissue surgery vs transvaginal mesh (TVM) surgery. 3 Long-term objective anatomical results have been reported to be superior in women with TVM compared with native tissue surgery, 4 which might be due to the fact that both the anterior and apical compartments are supported. Due to high numbers of side effects including contraction, mesh erosion, and pain with the first generation of vaginal meshes there is heated debate about vaginal mesh surgery with companies withdrawing their kits from the market and whole countries banning vaginal meshes after several food and drug administration (FDA) warnings and law suits.…”

Section: Introductionmentioning

confidence: 99%

1‐year outcome after treatment of uterovaginal prolapse with a 6‐point fixation mesh

Brandt

Kuszka

Niesel

et al. 2019

Neurourology and Urodynamics

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IntroductionThe aim of this study was to describe the safety and anatomical results of a surgical approach with a single‐incision 6‐point fixation vaginal mesh for the treatment of pelvic organ prolapse at perioperatively and at 1‐year follow‐up.Materials and MethodsThis was a prospective observational study of patients who underwent operation receiving an InGYNious anterior transvaginal mesh. All patients with symptomatic stage II prolapse or higher were included in the study. Exclusion criteria were the unwillingness or inability to give written informed consent, neuromuscular disorders, malignant diseases, previous radiation in the pelvis, or chronic pain syndrome. Every patient completed a structured questionnaire and a full physical examination according to the IUGA‐ICS POP‐Q staging system before the operation and at 1‐year follow‐up.ResultsTwo hundred fifty‐four patients (91%) were included in the study. The intraoperative complication rate was 7% with hemorrhage being the most common complication. Six patients (2.4%) had undergone reoperation for prolapse (four out of the six patients had reoperation in the posterior compartment) and were excluded from the objective outcome analysis. In the remaining 248 patients all POP‐Q measurements were significantly improved in the anterior and apical compartments. Similarly, urge urinary incontinence and voiding dysfunction improved significantly.ConclusionsIn this series, the objective outcome one year after the InGYNious mesh was good with low numbers of mesh‐related problems or reoperation for prolapse.

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Short term complications in mesh augmented vaginal repair of pelvic organ prolapse are not higher when compared with native tissue repair

2021

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Comparative analysis of early adverse events of pelvic organ prolapse repair with or without transvaginal mesh using Clavien‐Dindo classification

Abstract: Perioperative and postoperative adverse events were comparable regardless of the operative approach.

Cited by 12 publications

References 30 publications

The role of hydrodissection in native tissue repair of anterior vaginal wall defects

The role of hydrodissection in native tissue repair of anterior vaginal wall defects

1‐year outcome after treatment of uterovaginal prolapse with a 6‐point fixation mesh

Short term complications in mesh augmented vaginal repair of pelvic organ prolapse are not higher when compared with native tissue repair

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