Short‐term complications associated with the use of transvaginal mesh in pelvic floor reconstructive surgery: Results from a multi‐institutional prospectively maintained dataset

Caveney, Maxx; Haddad, Devin; Matthews, Catherine A.; Badlani, Gopal H.; Mirzazadeh, Majid

doi:10.1002/nau.23231

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…On the other hand, Hartmann et al have pointed out that short‐term complications (up to 1 year) after TVM surgery are 5%–11%, and long‐term complications are 5%–20% 2 . Mirzazadeh et al have also reported that patients undergoing mesh repair were more likely to experience at least one complication than those who undertook native tissue repair (9.28% vs. 6.15%, p < 0.001), with the overall complication rate also being higher in the mesh group (11.37% vs. 9.39%, p = 0.03) 10 . TVM surgery was introduced in Japan in 2005, and it employed a self‐cut mesh and custom‐made curved needle, instead of kit products, because mesh kits for TVM were not available.…”

Section: Discussionmentioning

confidence: 97%

Preliminary evaluation of the short‐term outcomes of polytetrafluoroethylene mesh for pelvic organ prolapse

Nakai

Hamuro

Kitada

et al. 2021

J of Obstet and Gynaecol

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Aim Tension‐free vaginal mesh (TVM) surgery using synthetic polypropylene (PP) soft mesh had spread rapidly. However, the frequency of mesh‐related postoperative complications had increased, and PP was banned in April 2019. In Japan, however, transvaginal surgery using polytetrafluoroethylene (PTFE) mesh had been approved. In this study, we evaluated the clinical outcome and quality of life (QOL) of the postoperative course using PP mesh and PTFE mesh (named “ORIHIME™”) in a combination surgery for utero‐sacral ligament suspension and anterior vaginal support using anterior TVM. Methods The vaginal hysterectomy and utero‐sacral ligament colpopexy augmented by anterior vaginal mesh implants using PP mesh and PTFE mesh were performed on patients with stage III to IV cystocele and uterine prolapse. The clinical outcome and QOL changes in their postoperative course were evaluated by comparing 15 cases of PP mesh and 13 cases of PTFE mesh. Results There was no difference between the PP group and PTFE group in characteristics. No mesh‐related complications occurred during the follow‐up period. With regard to the pelvic organ prolapse quantification (POP‐Q) score, no significant difference was found between the two groups. Comparing the postoperative QOL of both groups, the PTFE group had significantly higher values in two domains than PP group (SF‐12v2 questionnaire). Conclusions We used the world's first PTFE mesh to compare PP mesh with postoperative POP‐Q and QOL after the same surgery, with the same operator, and at the same institution. The results showed no significant difference between both mesh materials in the short‐term.

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Section: Discussionmentioning

confidence: 97%

Preliminary evaluation of the short‐term outcomes of polytetrafluoroethylene mesh for pelvic organ prolapse

Nakai

Hamuro

Kitada

et al. 2021

J of Obstet and Gynaecol

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“…Various TVM complications have been reported, including intraoperative bleeding, bladder injury, ureteral obstruction, infection, dyspareunia and mesh exposure 6,9 . The complication rate of POP surgery is reportedly significantly higher with TVM than with native tissue repair (11.37% vs 9.39%) 25 . Furthermore, TVM is associated with serious complications that might require reoperation.…”

Section: Discussionmentioning

confidence: 99%

“…6,9 The complication rate of POP surgery is reportedly significantly higher with TVM than with native tissue repair (11.37% vs 9.39%). 25 Furthermore, TVM is associated with serious complications that might require reoperation. Therefore, appropriate patient selection and adequate informed consent of the risks are necessary.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal polytetrafluoroethylene mesh surgery for pelvic organ prolapse: 1‐year clinical outcomes

et al. 2020

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Objectives To evaluate the safety and efficacy of transvaginal mesh surgery using a polytetrafluoroethylene mesh to treat pelvic organ prolapse. Methods This prospective observational study included women undergoing transvaginal mesh surgery for pelvic organ prolapse that used new polytetrafluoroethylene mesh cut into a shape similar to that of Elevate. We evaluated the subjective and objective outcomes at 3 and 12 months, as well as postoperative complication rates. Results This study included 55 patients. The pelvic organ prolapse quantification scores improved significantly at 3 and 12 months after surgery compared with scores before surgery. In four patients (7.3%), a pelvic examination showed stage 2 objective recurrence without subjective symptoms. Clavien–Dindo grades 2 and 3 perioperative complications were observed in 9.1% and 1.8% of the patients, respectively. Vaginal mesh exposure occurred in one patient (1.8%) at the time of the 3‐month follow‐up evaluation. The mesh was exposed at the proximal midline of the anterior vaginal wall. Conclusions These findings show the safe and effective use of the polytetrafluoroethylene mesh for transvaginal mesh surgery.

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“…NPWT for the pelvic cavity carries a risk of abdominal organ injury. Therefore, it is important to provide sufficient separation from internal organs to perform safe NPWT [ 13 ].According to past reports, pelvic floor reconstruction using skin flap and mesh implantation is effective for separating the abdominal and pelvic cavities [ [14] , [15] , [16] , [17] , [18] ]. In our method, these reconstruction techniques are unnecessary due to the suturing of the levator ani muscle.…”

Section: Discussionmentioning

confidence: 99%

Case series of in situ pelvic floor reconstruction combining levator ani suture and negative pressure wound therapy for abdominoperineal resection

Ito

Yoshida

Ohdaira

et al. 2019

Annals of Medicine and Surgery

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Background Abdominoperineal resection (APR) is a standard surgical technique for low rectum cancer with a low recurrence rate. There are some problems associated with APR such as perineal hernia and perineal surgical site infection. Recently, the prophylactic efficacy of negative pressure wound therapy (NPWT) for surgical site infection has been reported. Herein, we analyzed the efficacy of in situ pelvic floor reconstruction combining levator ani suture and NPWT after APR for perineal hernia and perineal surgical site infection. Methods We analyzed six patients treated by laparoscopic APR with NPWT combined with levator ani suture retrospectively. The primary endpoints were surgical site infection within 30 days and perineal hernia within 1 year after surgery. The day following surgery, we performed NPWT for the perineal wound using the VAC ® abdominal wound management system (KCI, San Antonio, TX, USA). Results There were four male and two female patients ranging in age from 69 to 86 years (mean: 76 years). The mean NPTW duration was 17 days (13–20 days). The length of the postoperative hospital stay was 14–22 days (median: 18 days). There was no patient with surgical site infection within 30 days or with perineal hernia within 1 year after surgery. Conclusion We experienced the in situ pelvic floor reconstruction combining levator ani suture and NPWT after laparoscopic APR for perineal hernia and perineal surgical site infection. This combination treatment was safe and may be effective for preventing surgical site infection and perineal hernia.

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Short‐term complications associated with the use of transvaginal mesh in pelvic floor reconstructive surgery: Results from a multi‐institutional prospectively maintained dataset

Abstract: The use of vaginal mesh for pelvic organ prolapse repair appears to result in a higher rate of perioperative complications than native tissue repair. Patients undergoing these procedures should be counselled preoperatively concerning these risks.

Cited by 15 publications

References 19 publications

Preliminary evaluation of the short‐term outcomes of polytetrafluoroethylene mesh for pelvic organ prolapse

Preliminary evaluation of the short‐term outcomes of polytetrafluoroethylene mesh for pelvic organ prolapse

Transvaginal polytetrafluoroethylene mesh surgery for pelvic organ prolapse: 1‐year clinical outcomes

Case series of in situ pelvic floor reconstruction combining levator ani suture and negative pressure wound therapy for abdominoperineal resection

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