The IUGA/ICS Classification of Synthetic Mesh Complications in Female Pelvic Floor Reconstructive Surgery: A Multicenter Study

Miklos, John R.; Chinthakanan, Orawee; Moore, R.D.; Mitchell, G.K.; Favor, S.; Karp, Deborah R.; Northington, Gina M.; Nogueiras, G.M.; Davila, G. Willy

doi:10.1016/j.jmig.2014.08.681

Cited by 17 publications

(24 citation statements)

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“…The use of mesh in prolapse surgery has reduced recurrence rates and has therefore been used more frequently over the last decade. However, the benefits must be weighed against the disadvantages, such as mesh erosion (5–10 %) and dyspareunia [24–26]. Sacrospinous hysteropexy is another uterus-preserving technique that is aimed at fixing the uterus to the sacrospinous ligament—most commonly to the right side to prevent lesions of the rectum.…”

Section: Discussionmentioning

confidence: 99%

Cervical amputation versus vaginal hysterectomy: a population-based register study

et al. 2016

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Introduction and hypothesisSurgical management of uterine prolapse varies greatly and recently uterus-preserving techniques have been gaining popularity. The aim of this study was to compare patient-reported outcomes after cervical amputation versus vaginal hysterectomy, with or without concomitant anterior colporrhaphy, in women suffering from pelvic organ prolapse.MethodWe carried out a population-based longitudinal cohort study with data from the Swedish National Quality Register for Gynecological Surgery. Between 2006 and 2013, a total of 3,174 patients with uterine prolapse were identified, who had undergone primary surgery with either cervical amputation or vaginal hysterectomy, with or without concomitant anterior colporrhaphy. Pre- and postoperative prolapse-related symptoms and patient satisfaction were assessed, in addition to complications and adverse events. Between-group comparisons were performed using univariate and multivariate logistic regression.ResultsThere were no differences between the two groups in neither symptom relief nor patient satisfaction. In both groups a total of 81 % of the women reported the absence of vaginal bulging 1 year after surgery and a total of 89 % were satisfied with the result of the operation. The vaginal hysterectomy group had a higher rate of severe complications than the cervical amputation group, 1.9 % vs 0.2 % (p < 0.001). The vaginal hysterectomy group also had a longer duration of surgery and greater perioperative blood loss, in addition to longer hospitalization.ConclusionsCervical amputation seems to perform equally well in comparison to vaginal hysterectomy in the treatment of uterine prolapse, but with less morbidity and a lower rate of severe complications.

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Section: Discussionmentioning

confidence: 99%

Cervical amputation versus vaginal hysterectomy: a population-based register study

et al. 2016

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“…Of note, this second July 2011 Public Health Notification did not comment specifically on the safety of using mesh for the treatment of SUI. Complications associated with midurethral mesh sling repair of SUI include pain, dyspareunia, mesh erosion and exposure …”

Section: Introductionmentioning

confidence: 99%

“…Complications associated with midurethral mesh sling repair of SUI include pain, dyspareunia, mesh erosion and exposure. 7 Interestingly, Rice et al found that there has been an increase in patient perceived mesh complications since the 2011 Public Health Notification, but that the actual frequency, type, and location of mesh complications has not changed. 8 Patient perceptions of vaginal mesh have been affected by a variety of factors in recent years, including advertisements for recruitment of plaintiffs for mesh litigation.…”

Section: Introductionmentioning

confidence: 99%

Stress urinary incontinence surgery trends in academic female pelvic medicine and reconstructive surgery urology practice in the setting of the food and drug administration public health notifications

Rac

Younger

Clemens

et al. 2016

Neurourology and Urodynamics

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These observed trends suggest a possible effect of the FDA Public Health Notifications regarding TVM on surgical practice for SUI in academic centers, even though they did not specifically warn against the use of synthetic mesh for this indication. Indications for surgery, complications, and outcomes were not evaluated during this retrospective study. However, such data may provide alternative insights into reasons for the observed trends. Neurourol. Urodynam. 36:1155-1160, 2017. © 2016 Wiley Periodicals, Inc.

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“…Problems after transvaginal placement include pain, exposure, extrusion, and dyspareunia . The first reports on vaginal mesh surgery included meshes that have been already withdrawn from the market with specific properties that are not preferable any more like heavy weight or transobturator arms.…”

Section: Introductionmentioning

confidence: 99%

“…Problems after transvaginal placement include pain, exposure, extrusion, and dyspareunia. 5,6 The first reports on vaginal mesh surgery included meshes that have been already withdrawn from the market with specific properties that are not preferable any more like heavy weight or transobturator arms. It is known, that lighter meshes are preferable due to lower numbers of complications while heavier meshes cause especially more protrusion or extrusion.…”

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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The IUGA/ICS Classification of Synthetic Mesh Complications in Female Pelvic Floor Reconstructive Surgery: A Multicenter Study

Cited by 17 publications

References 0 publications

Cervical amputation versus vaginal hysterectomy: a population-based register study

Cervical amputation versus vaginal hysterectomy: a population-based register study

Stress urinary incontinence surgery trends in academic female pelvic medicine and reconstructive surgery urology practice in the setting of the food and drug administration public health notifications

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

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