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Introduction: The prevalence of pelvic organ prolapse (POP) with aging is escalating alarmingly, and now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh (TVM) has been employed with increasing popularity in the treatment of POP until the end of the last decade. After the U.S. Drug and Food Administration (FDA) warnings in the years 2008 and 2011, the number of vaginal mesh operations has decreased dramatically.

Aim: The aim of the study was to evaluate and compare the anti-POP effectivity, the anti-stress incontinence (anti-SUI) efficacy, and the late (36 months) post-operative complications of the anterior vaginoplasty and the TVM operations.

Method: We analysed the clinical data from 120 patients with stage II-III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2013 and January 2014. Sixty patients underwent Kelly-Stoeckel vaginoplasty and the other 60 cases had TVM operation. The surgical complications were classified using the Clavien-Dindo (CD) classification system.

Results: The anti-POP (91.6% vs. 63.3%; p<0.001) and the anti-SUI efficacy (90% vs. 55%, p<0.001) were significantly higher in the TVM group than in the vaginoplasty group, while the overall extrusion rate was found 8.3% after a 3-year follow-up. The Clavien-Dindo score (CD) proved that the early post-operative complication profile was similar among the TVM patients as compared to the vaginoplasty group (p = 0.405).

Conclusion: Vaginal mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications. Orv Hetil. 2018; 159(10): 397-404.

Titel:	[Vaginal mesh operations in the urogynecological practice after the FDA warnings. Use or not to use mesh?]
Autor/in / Beteiligte Person:	Fekete, Z ; Körösi, S ; Németh, G
Zeitschrift:	Orvosi hetilap, Jg. 159 (2018-03-01), Heft 10, S. 397-404
Veröffentlichung:	2007- : Budapest : Akademiai Kiado ; <i>Original Publication</i>: Pest : Markusovszky Lajos, 2018
Medientyp:	academicJournal
ISSN:	0030-6002 (print)
DOI:	10.1556/650.2018.30963
Schlagwort:	Aged Aged, 80 and over Female Gynecologic Surgical Procedures statistics & numerical data Humans Hungary Middle Aged Minimally Invasive Surgical Procedures statistics & numerical data Patient Satisfaction Surgical Mesh adverse effects United States United States Food and Drug Administration Urinary Incontinence, Stress epidemiology Uterine Prolapse epidemiology Postoperative Complications epidemiology Surgical Mesh statistics & numerical data Urinary Incontinence, Stress surgery Uterine Prolapse surgery
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: Hungarian Transliterated Title: Hüvelyi hálóműtétek gyakorlata az amerikai korlátozó figyelmeztetés után. Merjem, vagy ne merjem? Publication Type: Journal Article Language: Hungarian [Orv Hetil] 2018 Mar; Vol. 159 (10), pp. 397-404. MeSH Terms: Postoperative Complications / epidemiology ; Surgical Mesh / statistics & numerical data ; Urinary Incontinence, Stress / surgery ; Uterine Prolapse / surgery ; Aged ; Aged, 80 and over ; Female ; Gynecologic Surgical Procedures / statistics & numerical data ; Humans ; Hungary ; Middle Aged ; Minimally Invasive Surgical Procedures / statistics & numerical data ; Patient Satisfaction ; Surgical Mesh / adverse effects ; United States ; United States Food and Drug Administration ; Urinary Incontinence, Stress / epidemiology ; Uterine Prolapse / epidemiology Contributed Indexing: Keywords: Clavien–Dindo classification; Clavien–Dindo-klasszifikáció; SUI with POP–Q II–III; SUI és POP–Q II–III; anterior vaginoplasty; complications; komplikációk; mellső hüvelyplastica; transvaginal mesh; transvaginalis hálóműtét Entry Date(s): Date Created: 20180306 Date Completed: 20180424 Latest Revision: 20180424 Update Code: 20231215

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[Vaginal mesh operations in the urogynecological practice after the FDA warnings. Use or not to use mesh?]