Recurrence of Prolapse After Transvaginal Mesh Excision

George, Ajith; Mattingly, Marlena; Woodman, Patrick J.; Hale, Douglass S.

doi:10.1097/ogx.0b013e3182a85094

Cited by 5 publications

(14 citation statements)

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“…Only four studies specified that women underwent initial mesh surgery for POP, and eight studies specified that the initial mesh surgery was for SUI . The remaining studies included women who had initial mesh surgery for POP and/or SUI, but did not report outcomes separately for these women.…”

Section: Resultsmentioning

confidence: 99%

Management of mesh complications following surgery for stress urinary incontinence or pelvic organ prolapse: a systematic review

Carter

Fou

Whiter

et al. 2019

BJOG

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Background Mesh surgery for stress urinary incontinence or pelvic organ prolapse can result in complications such as mesh exposure, mesh extrusion, voiding dysfunction, dyspareunia, and pain. There is limited knowledge or guidance on the effective management for mesh‐related complications. Objective To determine the best management of mesh complications; a systematic review was conducted as part of the national clinical guideline ‘Urinary incontinence (update) and pelvic organ prolapse in women: management’. Search strategy Search strategies were developed for each indication for referral. Selection criteria Relevant interventions included complete or partial mesh removal, mesh division, and non‐surgical treatments such as vaginal estrogen. Data collection and analysis Characteristics and outcome data were extracted, and as a result of the heterogeneous nature of the data a narrative synthesis was conducted. Main results Twenty‐four studies were included; five provided comparative data and four studies stated the indication for referral. Reported outcomes (including pain, dyspareunia, satisfaction, quality of life, incontinence, mesh exposure, and recurrence) and the reported incidences of these varied widely. Conclusions The current evidence base is limited in quantity and quality and does not permit firm recommendations to be made on the most effective management for mesh‐related complications. Robust data are needed so that mesh complications can be managed effectively in the future. Tweetable abstract Systematic review demonstrates that the outcomes following mesh revision surgery are highly variable.

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Section: Resultsmentioning

confidence: 99%

Management of mesh complications following surgery for stress urinary incontinence or pelvic organ prolapse: a systematic review

Carter

Fou

Whiter

et al. 2019

BJOG

View full text Add to dashboard Cite

show abstract

“…Consistent with other reports, we were able to perform most of the surgeries vaginally. 9,12,13 Our study demonstrated that mesh removal in multiple compartments is associated with significantly greater operative time and blood loss. Other studies have not previously reported the amount of mesh removed, and this may be the reason that operative time can vary from a reported 21 minutes to more than 3 hours.…”

Section: Discussionmentioning

confidence: 88%

“…Given the proximity to other structures, this overall number was low. George et al 9 reported a single cystotomy during mesh removal surgery but did not report any injuries to the urethra or rectum in their study involving 71 patients. Additionally, other postoperative complications reported in other studies include hematomas, diarrhea, urinary tract infections, and small bowel obstructions.…”

mentioning

confidence: 96%

“…Additionally, other postoperative complications reported in other studies include hematomas, diarrhea, urinary tract infections, and small bowel obstructions. 9,13 A strength of our study is that this is a large singlesite study investigating the complications related to mesh removal surgery. This study is novel in that it reports the increased morbidity involved with removing mesh from multiple vaginal compartments compared with the morbidity of removing mesh from only one compartment.…”

mentioning

confidence: 98%

“…[4][5][6][7][8] Recent studies focus on outcomes during surgical removal of mesh and patient-based outcomes after the removal of mesh. [9][10][11][12] Although vaginal mesh removal has become more common in tertiary health care centers, it remains difficult to counsel patients on expected risks of surgery given the sparse published data on associated risks. Intuitively, resecting larger portions of mesh would carry a greater morbidity compared with smaller portions, but this is not established in the literature.…”

mentioning

confidence: 99%

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