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Introduction and Hypothesis: The use of mesh in pelvic organ prolapse (POP) surgery has become a widespread treatment option, but carries a risk of specific complications. The objective was to report the rate and type of reoperation for mesh-related complications after pelvic organ prolapse surgery in an urogynecological referral center over a period of 8 years.

Methods: A retrospective study was carried out including all patients operated for a mesh complication after prolapse surgery between September 2006 and September 2014 in the urogynecology unit in Nîmes hospital.

Results: Sixty-nine mesh complications were recorded among the 67 patients included. Surgical treatment of mesh-related complications accounted for 7% of all pelvic surgeries performed in our center. Thirty-two patients (47.8%) were referred from other centers and 35 patients (52.2%) were initially operated in our unit. The global rate of reintervention for mesh-related complications after prolapse repair performed in our unit was 2.8%. Of 69 mesh complications, 48 patients (71.6%) had transvaginal mesh (TVM) and 19 patients (28.4%) sacrocolpopexy (SCP). The indication for surgery was a symptomatic or large vaginal erosion (47.8%), symptomatic mesh contraction (20.3%), and infection (11.6%). The most frequent primary symptom was pelvic/perineal pain or dyspareunia (33.3% of cases). The mean time between initial mesh surgery and the reoperation for a complication was 33.4 months (95% CI, 24.5 to 42.2). Eleven patients (15.9%) required several interventions. In total, 77.9% of patients experienced complete recovery of symptoms after surgical management.

Conclusion: In a referral center the global rate of reinterventions for mesh-related complications after POP repair is 2.8%. The surgical treatment of mesh complications appears to be a safe and effective procedure with cure of the symptoms in most cases.

Titel:	Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center.
Autor/in / Beteiligte Person:	Warembourg, S ; Labaki, M ; de Tayrac R ; Costa, P ; Fatton, B
Link:	View record at Springer (Volltext)
Zeitschrift:	International urogynecology journal, Jg. 28 (2017-08-01), Heft 8, S. 1139-1151
Veröffentlichung:	London : Springer, 2017
Medientyp:	academicJournal
ISSN:	1433-3023 (electronic)
DOI:	10.1007/s00192-016-3256-5
Schlagwort:	Adult Aged Aged, 80 and over Dyspareunia etiology Dyspareunia surgery Female Humans Middle Aged Pelvic Pain etiology Pelvic Pain surgery Postoperative Complications etiology Retrospective Studies Tertiary Care Centers Treatment Outcome Vagina surgery Pelvic Organ Prolapse surgery Postoperative Complications surgery Reoperation statistics & numerical data Surgical Mesh adverse effects
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Evaluation Study; Journal Article Language: English [Int Urogynecol J] 2017 Aug; Vol. 28 (8), pp. 1139-1151. <i>Date of Electronic Publication: </i>2017 Feb 01. MeSH Terms: Pelvic Organ Prolapse / surgery ; Postoperative Complications / surgery ; Reoperation / statistics & numerical data ; Surgical Mesh / adverse effects ; Adult ; Aged ; Aged, 80 and over ; Dyspareunia / etiology ; Dyspareunia / surgery ; Female ; Humans ; Middle Aged ; Pelvic Pain / etiology ; Pelvic Pain / surgery ; Postoperative Complications / etiology ; Retrospective Studies ; Tertiary Care Centers ; Treatment Outcome ; Vagina / surgery References: Int Urogynecol J. 2011 Nov;22(11):1395-404. (PMID: 21681595) ; Int Urogynecol J Pelvic Floor Dysfunct. 2009 Aug;20(8):893-6. (PMID: 19513574) ; Int Urogynecol J. 2015 Mar;26(3):353-8. (PMID: 25323309) ; Am J Obstet Gynecol. 2000 Aug;183(2):277-85. (PMID: 10942459) ; Am J Obstet Gynecol. 2012 Jan;206(1):83.e1-7. (PMID: 21963098) ; J Urol. 2012 May;187(5):1674-9. (PMID: 22425114) ; Int Urogynecol J. 2010 Apr;21(4):423-30. (PMID: 19936589) ; Obstet Gynecol. 2011 Sep;118(3):629-36. (PMID: 21860293) ; Gynecol Obstet Fertil. 2005 Dec;33(12):970-4. (PMID: 16324871) ; Int Urogynecol J. 2014 Mar;25(3):313-8. (PMID: 24217793) ; Eur J Obstet Gynecol Reprod Biol. 2014 Apr;175:194-8. (PMID: 24461139) ; Am J Obstet Gynecol. 2008 Dec;199(6):703.e1-7. (PMID: 18845292) ; BJOG. 2008 Jan;115(1):22-30. (PMID: 18053100) ; Int Urogynecol J. 2011 May;22(5):505-6. (PMID: 21461707) ; Curr Opin Urol. 2008 Jul;18(4):377-82. (PMID: 18520758) ; Urology. 2013 Jan;81(1):43-8. (PMID: 23200966) ; J Gynecol Obstet Biol Reprod (Paris). 2010 Dec;39(8):672-4. (PMID: 20832190) ; Int Urogynecol J. 2011 Nov;22(11):1429-35. (PMID: 21789657) ; Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jul;18(7):743-52. (PMID: 17131170) ; Am J Obstet Gynecol. 2008 Dec;199(6):678.e1-4. (PMID: 18845282) ; Obstet Gynecol. 2004 Oct;104(4):805-23. (PMID: 15458906) ; Int Urogynecol J Pelvic Floor Dysfunct. 2009 Jan;20(1):103-11. (PMID: 18779916) ; J Gynecol Obstet Biol Reprod (Paris). 2013 Nov;42(7):628-38. (PMID: 24095180) ; Am J Obstet Gynecol. 2005 Mar;192(3):795-806. (PMID: 15746674) ; Am J Obstet Gynecol. 2014 Feb;210(2):163.e1-8. (PMID: 24126300) ; Int Urogynecol J. 2013 Nov;24(11):1859-72. (PMID: 24142061) ; Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jan;18(1):73-9. (PMID: 16391882) ; Am J Obstet Gynecol. 2004 Jan;190(1):20-6. (PMID: 14749629) ; J Gynecol Obstet Biol Reprod (Paris). 2006 Nov;35(7):678-84. (PMID: 17088768) ; Int Urogynecol J. 2011 Jan;22(1):3-15. (PMID: 21140130) ; Am J Obstet Gynecol. 2007 Dec;197(6):615.e1-5. (PMID: 18060951) ; Int Urogynecol J. 2016 Jun;27(6):933-8. (PMID: 26690360) ; Neurourol Urodyn. 2016 Jun;35(5):589-94. (PMID: 25874639) ; Obstet Gynecol. 2010 Feb;115(2 Pt 1):325-30. (PMID: 20093906) ; Cochrane Database Syst Rev. 2016 Feb 09;2:CD012079. (PMID: 26858090) ; Obstet Gynecol. 2014 Jan;123(1):134-9. (PMID: 24463673) ; Obstet Gynecol. 2009 Feb;113(2 Pt 1):367-73. (PMID: 19155908) ; Ann Surg. 2004 Aug;240(2):205-13. (PMID: 15273542) ; Int Urogynecol J Pelvic Floor Dysfunct. 2006 Jun;17(4):315-20. (PMID: 16228121) ; Cochrane Database Syst Rev. 2016 Oct 01;10 :CD012376. (PMID: 27696355) ; Acta Obstet Gynecol Scand. 2005 Jan;84(1):79-84. (PMID: 15603572) ; Int Urogynecol J Pelvic Floor Dysfunct. 2007 Sep;18(9):1059-64. (PMID: 17219252) ; Int Urogynecol J Pelvic Floor Dysfunct. 2009 May;20(5):523-31. (PMID: 19209374) ; Eur J Obstet Gynecol Reprod Biol. 2012 Dec;165(2):170-80. (PMID: 22999444) ; Int Urogynecol J Pelvic Floor Dysfunct. 2009 Jan;20(1):11-7. (PMID: 18806911) ; Int Urogynecol J. 2014 Jun;25(6):817-22. (PMID: 24515543) ; Cent European J Urol. 2014;67(3):296-301. (PMID: 25247091) Contributed Indexing: Keywords: Pelvic organ prolapse; Pelvic pain; Post-operative complication; Sacrocolpopexy; Trans-vaginal mesh; Vaginal erosion Entry Date(s): Date Created: 20170203 Date Completed: 20180423 Latest Revision: 20220408 Update Code: 20231215

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Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center.