Functional outcomes for surgical revision of synthetic slings performed for voiding dysfunction: a retrospective study

Agnew, Gerard; Dwyer, Peter; Rosamilia, Anna; Edwards, Geoffrey; Lee, Joseph K.

doi:10.1016/j.ejogrb.2012.04.005

Cited by 25 publications

(25 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The analysis of the available studies showed a similar subjective cure rate of 79–100% for different techniques ( Figure 3 ). The rate of reoperations was higher if an endoscopic or transvaginal access were chosen [ 18 , 19 , 21 , 22 , 24 , 30 ]. However, the hospital stay, operation time, and postoperative pain were higher in the case of laparoscopic mesh excision [ 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three different surgical procedures were analysed (simple sling division, partial resection, and concomitant SUI procedure). Taking into account the results of the findings ( Table 1 ), the authors changed their strategy to divide synthetic midurethral slings lateral to the urethra and then carefully perform cystourethroscopy to ensure that no urinary tract injury has occurred [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature

Barski

Deng

2015

BioMed Research International

View full text Add to dashboard Cite

Purpose. To evaluate the surgical treatment concepts for the complications related to the implantation of mesh material for urogynecological indications. Materials and Methods. A review of the current literature on PubMed was performed. Results. Only retrospective studies were detected. The rate of mesh-related complications is about 15–25% and mesh erosion is up to 10% for POP and SUI repair. Mesh explantation is necessary in about 1-2% of patients due to complications. The initial approach appears to be an early surgical treatment with partial or complete mesh resection. Vaginal and endoscopic access for mesh resection is favored. Prior to recurrent surgeries, a careful examination and planning for the operation strategy are crucial. Conclusions. The data on the management of mesh complication is scarce. Revisions should be performed by an experienced surgeon and a proper follow-up with prospective documentation is essential for a good outcome.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature

Barski

Deng

2015

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…The risk of sling exposure was significantly lower in the RP slings than in the transobturator sling ( P = 0.03). Revisions performed predominantly for pain or voiding difficulty were excluded and have been addressed in an earlier report from our unit . The selection of patients for this analysis is outlined in Figure .…”

Section: Resultsmentioning

confidence: 99%

Mid‐urethral sling revision for mesh exposure–long‐term outcomes of two surgical techniques from a comparative clinical retrospective cohort study

Karmakar

Dwyer

Nikpoor

2020

BJOG

View full text Add to dashboard Cite

Objective To compare vaginal closure with versus without sling excision in the management of vaginal sling exposure following mid‐urethral sling (MUS). Design Clinical retrospective cohort study. Setting Tertiary urogynaecological centre in Australia. Population Women with urodynamic stress urinary incontinence (SUI) who had a MUS (n = 2823) during 1999–2017 with a follow‐up period up to December 2018. Thirty‐three women (1%) had sling exposure and 31 required surgical intervention (1%). Methods Clinical review with analysis of surgical database and patient records. Main outcome measures The primary outcome was successful closure and resolution of exposure‐related symptoms without the need for re‐surgery. Secondary outcomes were repeat procedure and recurrent incontinence following revision. Results Mean follow up was 103 months. Of the 20 women with a primary excision and closure approach, 19 had successful closure. Seven of 11 women with simple vaginal closure without excision needed another surgery for recurrent mesh exposure. Recurrence of stress incontinence did not occur in any of the four who had ‘successful’ closure without excision. Of those who had sling division/removal without a concomitant stress continence procedure, 32% (7/22) required further surgery. Conclusion Sling excision and repair have better outcomes with less recurrence of sling exposure compared with simple closure. Following sling removal, one of three women will develop SUI recurrence and require surgery. Tweetable abstract #Slingexcision &repair leads to less recurrence of exposure versus #simpleclosure for #slingmeshexposure.

show abstract

“…Furthermore, there are data to suggest that delayed urethrolysis may be associated with persistent voiding dysfunction [59]. However, Agnew et al reported the opposite with 6/45 (13%) of the early revision group and 2/18 (11%) of the late revision group experiencing persistent voiding dysfunction after revision [54].…”

Section: Voiding Dysfunctionmentioning

confidence: 94%

“…Short case series have addressed the management of women with specific symptoms after MUS placement such as chronic pelvic pain, voiding dysfunction, dyspareunia/sexual dysfunction, urogenital fistulas and vaginal mesh extrusion or erosion into the lower urinary tract [32,33,39,40]. TABLE 1 summarizes the majority of published literature with functional outcomes relating to MUS removal or lysis [41][42][43][44][45][46][47][48][49][50][51][52][53][54]. Although most of the series are from tertiary referral centers, the pervading message is that the rate of these removal procedures is on the rise.…”

Section: Management and Outcomesmentioning

confidence: 99%

Meshology: a fast-growing field involving mesh and/or tape removal procedures and their outcomes

Lee

Bacsu

Zimmern

2014

Expert Review of Medical Devices

View full text Add to dashboard Cite

Stress urinary incontinence and pelvic organ prolapse are two of the commonest conditions affecting women today. It is associated with significant compromise to quality of life. Through the years, there has been an evolution of technique and graft material to augment repairs for durability. Transvaginal placements of synthetic mid-urethral slings and vaginal meshes have largely superseded traditional tissue repairs in the current era because of presumed efficacy and ease of implant with device 'kits'. The use of synthetic material has generated novel complications, including mesh extrusion, pelvic and vaginal pain and mesh contraction. In this review, our aim is to discuss the management and outcomes associated with mesh removal. In addition, we will briefly review the safety communications issued by the US FDA on transvaginal mesh placement and a new classification system for complications arising from the use of synthetic graft endorsed by both the International Continence Society and International Urogynecological Association.

show abstract

Functional outcomes for surgical revision of synthetic slings performed for voiding dysfunction: a retrospective study

Cited by 25 publications

References 13 publications

Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature

Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature

Mid‐urethral sling revision for mesh exposure–long‐term outcomes of two surgical techniques from a comparative clinical retrospective cohort study

Meshology: a fast-growing field involving mesh and/or tape removal procedures and their outcomes

Contact Info

Product

Resources

About