OBJECTIVES: To explore the risk factors for mesh erosion after female pelvic floor reconstructive surgery based on published literature.
MATERIALS AND METHODS: A systematic literature search of the Pubmed, Embase, Cochrane Library, CBM, CNKI and VIP databases was performed to identify the studies related to the risk factors for mesh erosion after female pelvic floor reconstruction published before December 2014. Summary unadjusted odds ratio (OR) with 95% confidence interval (CI) was calculated to assess the strength of associations between the factors and mesh erosion.
RESULTS: A total of 25 studies containing 7084 patients were included in our systematic review and meta-analysis. Statistically significant differences in mesh erosion after female pelvic floor reconstruction were found in elder age vs. younger age (OR = 0.96, 95% CI: 0.94-0.98), more parities vs. less parities (OR = 1.27, 95% CI: 1.07-1.51), the presence of premenopausal / estrogen replacement therapy (ERT) (OR = 1.36, 95% CI: 1.03-1.79), diabetes mellitus (OR = 1.87, 95% CI: 1.35-2.57), smoking (OR = 2.35, 95% CI: 1.80-3.08), concomitant pelvic organ prolapse (POP) surgery (OR = 0.37, 95% CI: 0.16-0.84), concomitant hysterectomy (OR = 1.46, 95% CI: 1.03-2.07), preservation of uterus at surgery (OR = 0.22, 95% CI: 0.08-0.63), and senior surgeons operation vs. junior surgeons operation (OR = 0.42, 95% CI: 0.30-0.58).
CONCLUSION: Our study indicated that younger age, more parities, premenopausal / ERT, diabetes mellitus, smoking, concomitant hysterectomy, and junior surgeons operation were significant risk factors for mesh erosion after female pelvic floor reconstructive surgery. Moreover, concomitant POP surgery and preservation of uterus may be the potential protective factors for mesh erosion.
Deng T, Liao B, Luo D, Shen H, Wang K. Are you the author?
Department of Urology Surgery, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, P.R. China.
Reference: BJU Int. 2015 Apr 24. Epub ahead of print.