Efficacy of surgical revision of mesh complications in prolapse and urinary incontinence surgery
- PDF / 319,060 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 8 Downloads / 204 Views
ORIGINAL ARTICLE
Efficacy of surgical revision of mesh complications in prolapse and urinary incontinence surgery Claudia R. Kowalik 1
&
Mariëlle M. E. Lakeman 2 & Sandra E. Zwolsman 1 & Jan-Paul W. R. Roovers 1
Received: 4 June 2020 / Accepted: 14 September 2020 # The Author(s) 2020
Abstract Introduction and hypothesis Women with mesh-related complications in prolapse (POP) and stress-urinary incontinence (SUI) surgery may benefit from operative mesh resection to alleviate symptoms. We hypothesized that mesh resection would alleviate symptoms and aimed to evaluate risks and benefits in these women. Methods We carried out a cross-sectional study. Primary outcome was improvement specified as better, unchanged or worsened symptoms after mesh revision surgery. Secondary outcomes were health-related quality of life (HrQol) scores of validated questionnaires, surgical characteristics and physical findings at follow-up visits. Descriptive data were reported with mean and medians. Associations were calculated with Spearman correlation coefficient and chisquare test to determine statistical differences between groups. Results Fifty-nine women who underwent mesh revision surgery between 2009 and 2016 were included. After a median follow-up of 1.7 (IQR: 1.1–2.4) years, 44 women (75%) reported improvement of symptoms. No significant surgical or patient characteristics were identified that could differentiate which patients did or did not experience cure or complications.A trend was observed to better HrQol scores in women who reported overall improvement after mesh revision surgery. Seventeen (29%) women needed a subsequent operation after mesh removal. Conclusions This cross-sectional study shows that mesh revision surgery alleviates symptoms in 75% of women with mesh-related complications. Type of revision surgery and individual characteristics did not seem to matter to the individual chance of cure or complications. These data can facilitate the counseling of women considering mesh revision surgery. Keywords Complications . Pelvic organ prolapse . Surgery
Introduction * Claudia R. Kowalik [email protected] Mariëlle M. E. Lakeman [email protected] Sandra E. Zwolsman [email protected] Jan-Paul W. R. Roovers [email protected] 1
Department of Obstetrics and Gynecology, Amsterdam University Medical Centre, Room H4-262, PO Box 22660, 1100, DD Amsterdam, The Netherlands
2
Department of Obstetrics and Gynecology, BovenIJ ziekenhuis, Statenjachtstraat 1, Po box 37610, 1030, BD Amsterdam, The Netherlands
Various surgical procedures for POP exist, but the perfect operation combining optimal cure rates and minimal morbidity has yet to be found. The high failure rates of conventional surgery for POP resulted in the introduction of synthetic vaginal meshes [1]. The rationale for using these meshes is that they trigger fibroblasts to produce new collagen and elastin as part of the foreign body response they induce. Comparative studies have shown that the use of vaginal implants results in impro
Data Loading...
