This was retrospective chart review of patients who underwent vaginal prolapse surgery with synthetic mesh between May 1991 and October 2010 at a single academic institution. Details regarding past medical and surgical history, index surgery performed, perioperative complications, and relevant subsequent operations were abstracted; current symptoms, signs and patient satisfaction were ascertained from written surveys and pelvic exams when available. Descriptive analyses were performed to characterize the sample. Results: Among 804 potential patients identified, 158 patients were eligible for inclusion. Overall, 33/158 (21%) women underwent mesh-related reoperation; associated factors are outlined in Table 1. The rate of mesh-related complication was 34%(n=54); 30%(48) had mesh extrusion into the vagina and 1% had mesh erosion into the bladder(1) or rectum(1). Among 43 questionnaires received, 74 %(32) report symptoms are better, 9%(4) are the same, and 16%(7) are worse. Regarding surgical satisfaction, 42% (18) are very satisfied, 28 %(12) somewhat satisfied, 14%(6) somewhat unsatisfied, and 16%(7) very unsatisfied.
The authors reported when followed for up to 25 years, almost one third of patients who had a mesh augmented transvaginal repair of prolapse required a subsequent operation. Over 20% of patients required reoperation for a mesh related complication. Younger women, women with apical mesh placed, and women who experienced intraoperative urinary tract injury were more likely to require reoperation.
Presented by: Margaret Knoedler, MD
Co- Authors: Hayley Barnes MD, Elizabeth Meller BS, Caroline Kieserman-Shmokler MD, Dobie Giles MD, MS, Christine Heisler MD, MS, Heidi Brown MD, MAS and Sarah McAchran MD, Madisonm WI
Written by: Bilal Farhan, MD, Female Urology Fellow and Voiding Dysfunction, Department of Urology, University of California, Irvine at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting (SUFU 2018), February 27-March 3, 2018, Austin, Texas