Outcomes following treatment for pelvic floor mesh complications.

Abstract

INTRODUCTION AND HYPOTHESIS:

Our aim was to determine symptoms and degree of improvement in a cohort of women who presented following treatment for vaginal mesh complications.

METHODS:

This study was a follow-up to a multicenter, retrospective study of women who presented to four tertiary referral centers for management of vaginal-mesh-related complications. Study participants completed a one-time follow-up survey regarding any additional treatment, current symptoms, and degree of improvement from initial presentation.

RESULTS:

Two hundred and sixty women received surveys; we had a response rate of 41.1 % (107/260). Complete data were available for 101 respondents. Survey respondents were more likely to be postmenopausal (p = 0.006), but otherwise did not differ from nonrespondents. Fifty-one percent (52/101) of women underwent surgery as the primary intervention for their mesh complication; 8 % (4/52) underwent a second surgery; 34 % (17/52) required a second nonsurgical intervention. Three patients required three or more surgeries. Of the 30 % (30/101) of respondents who reported pelvic pain prior to intervention, 63 % (19/30) reported improvement, 30 % (9/30) were worse, and 7 % (2/30) reported no change. Of the 33 % (33/101) who reported voiding dysfunction prior to intervention, 61 % (20/33) reported being at least somewhat bothered by these symptoms.

CONCLUSIONS:

About 50 % of women with mesh complications in this study underwent surgical management as treatment, and <10 % required a second surgery. Most patients with pain preintervention reported significant improvement after treatment; however, almost a third reported worsening pain or no change after surgical management. Less than half of patients with voiding dysfunction improved after intervention.

• Authors: C A Unger, S Abbott, J M Evans, K Jallad, K Mishra, M M Karram, C B Iglesia, C R Rardin, M D Barber
• Journal: International urogynecology journal (Int Urogynecol J) Vol. 25 Issue 6 Pg. 745-9 (Jun 2014) ISSN: 1433-3023 [Electronic] England
• PMID: 24318564 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Equipment Failure
• Female
• Follow-Up Studies
• Humans
• Multicenter Studies as Topic
• Pelvic Floor (surgery)
• Postoperative Complications (etiology, therapy)
• Retrospective Studies
• Surgical Mesh (adverse effects)
• Treatment Outcome
• Vagina