Outcome of vaginal mesh reconstructive surgery in multiparous compared with grand multiparous women: Retrospective long-term follow-up

Abstract

We aimed to compare the long-term surgical outcome and complications of multiparous and grand multiparous women undergoing reconstructive surgery with vaginal mesh implants for repair of pelvic organ prolapse. This retrospective, long-term follow-up (28.17±20.7 months) comprised 113 women who underwent surgical reconstructive surgery with vaginal polypropylene mesh in a high parity rate population medical center. The women were divided into 2 groups (multiparous and grand multiparous) and each group was evaluated for objective and subjective surgical outcome. Patient demographics and surgical data were retrieved from electronic medical records. Outcome measure included POP-Q exam as objective outcome and validated Pelvic Floor Distress Inventory questionnaire (PFDI) to assess subjective outcome. Average age of patients was 62±7.9 (range 42–83) years. Average parity was 5.6±3.1 (range 1–14). There were 54 (47.7%) multiparous women and 59 (52.3%) grand multiparous women. The grand multiparous women were younger than the multiparous women and had a significantly higher degree of prolapse. At the last follow-up, the only significant difference was related to symptoms of an overactive bladder. In conclusion, long-term follow-up demonstrates that vaginal mesh surgery in grand multiparous women offers anatomical and subjective cure rates comparable to multiparous women.

Anterior Colporrhaphy: Outcomes Assessment in Relation to Pre-Operative Urinary Symptoms

“…A study by Akeme and Segni (2012) have shown similar results of mean age 42.43 ± 10.4 years and mean parity of 6.5± 2.64. Results were found in other studies as revealed by Levy et al (2017), in which the mean age 62.0±7.9 (42-83) years, and BMI was 27.33 . Mean parity was 5.6 ± 3.7 (1-14) and higher percentage of the third-degree vaginal prolapse 19,20 In our study, the patients were younger, symptomatic earlier and with higher parity than in other studies, and pelvic floor muscle damage during the second stage of labor has been attributed.…”

“…Results were found in other studies as revealed by Levy et al (2017), in which the mean age 62.0±7.9 (42-83) years, and BMI was 27.33 . Mean parity was 5.6 ± 3.7 (1-14) and higher percentage of the third-degree vaginal prolapse 19,20 In our study, the patients were younger, symptomatic earlier and with higher parity than in other studies, and pelvic floor muscle damage during the second stage of labor has been attributed. The higher level of pelvic trauma secondary to high parity was documented in this study (63% had history of difficult labor).…”

Repair of recurrent rectocele with posterior colporrhaphy or non-absorbable polypropylene mesh—patient-reported outcomes at 1-year follow-up

“…The evaluations of mesh use in prolapse surgery are often unstratified, where the individual vaginal compartments are either pooled or unspecified, or assumed to be of equal impact, and this produces ambiguous results regarding site-specific evaluations of impact [3, 14]. From continuous monitoring of GynOp register items, we know that the posterior vaginal wall is the second most common site of POP.…”

Comparative analysis of transvaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site sacrocolpopexy for pelvic organ prolapse: A propensity score matching study

“…Perioperative and mid-term follow-up complications: The incidence (%) of injury to adjacent organs and massive hemorrhage (>500 ml [ [7] , [8] , [9] ]) during the operation was measured. Perioperative complication incidence (%) included postoperative fever, intestinal obstruction, and urinary retention (>150 ml) [ 10 ].…”