Our objective was to compare the recollection of preoperative counseling regarding mesh for pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) among women with or without a mesh-related complication (MRC). We hypothesized that the patients who had MRC would better recollect counseling regarding complications associated with mesh.
We conducted a retrospective cohort study among women who had prior implantation of synthetic, non-absorbable mesh for POP and/or SUI at least 3 months prior who presented with or without a MRC. The primary outcome was the proportion of women who recalled being counseled preoperatively about the risk of mesh exposure.
Ninety-six women were included in the final analysis (50 MRC; 46 no MRC). MRC women presented further in time from the index surgery [median 69 months [IQR 26-115] vs 12 months (IQR 6-64), p < 0.01]. After adjustment for time since surgery and age, MRC women were significantly less likely to recall being counseled about the possibility of any MRC [19/50 (38%) vs 32/44 (73%), aOR 0.29, 95% CI 0.11-0.79, p = 0.01]. They were also less likely to report they would undergo the same surgery again 5-point Likert scale [median 3 (IQR 1-4) vs 5 (IQR 3-5), 5-point Likert scale, p < 0.01], less satisfied with their mesh surgery [median 1 (IQR 1-3) vs 5 (IQR 3-5), 5-point Likert scale, p < 0.01] and recommended improved preoperative counseling [27/50 (54%) vs 6/46 (13%), p < 0.01].
Women who experienced MRC were less likely to recall being counseled about the possibility of MRC and report more unmet needs regarding perioperative counseling than women without MRC.
Archives of gynecology and obstetrics. 2021 Jan 03 [Epub ahead of print]
Deslyn T G Hobson, Casey L Kinman, Jeremy T Gaskins, Sean L Francis, Collin M McKenzie, J Ryan Stewart, Ankita S Gupta, Kate V Meriwether
Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA. ., Baylor Scott and White Medical Center, Irving, TX, USA., Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA., Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Women's Health, University of Louisville School of Medicine, Louisville, KY, USA., Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Norton Healthcare, Norton Urogynecology Center, Louisville, KY, USA., Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.