Commentary on “Lightweight transvaginal mesh is associated with lower mesh exposure rates than heavyweight mesh” by Dykes et al.

2020 ◽  
Vol 31 (9) ◽  
pp. 1793-1793
Author(s):  
Marianne Koch
2020 ◽  
Vol 31 (9) ◽  
pp. 1785-1791 ◽  
Author(s):  
Nicola Dykes ◽  
Debjyoti Karmakar ◽  
Lynsey Hayward

Author(s):  
Junfang Yang ◽  
Kun Zhang ◽  
Jinsong Han ◽  
Yiting Wang ◽  
Ying Yao ◽  
...  

Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design:This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data. Conclusion: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however,concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.


2005 ◽  
Vol 17 (4) ◽  
pp. 315-320 ◽  
Author(s):  
Pierre Collinet ◽  
Franck Belot ◽  
Philippe Debodinance ◽  
Edouard Ha Duc ◽  
Jean-Philippe Lucot ◽  
...  

2016 ◽  
Vol 129 (15) ◽  
pp. 1795-1799 ◽  
Author(s):  
Ke Niu ◽  
Yong-Xian Lu ◽  
Wen-Jie Shen ◽  
Ying-Hui Zhang ◽  
Wen-Ying Wang

Author(s):  
Kumiko Kato ◽  
Shoji Suzuki ◽  
Akinobu Ishiyama ◽  
Hideji Kawanishi ◽  
Hirotaka Matsui ◽  
...  

2020 ◽  
Author(s):  
Chang Shi ◽  
Ying Zhao ◽  
Qing Hu ◽  
Runqi Gong ◽  
Yitong Yin ◽  
...  

Abstract Background The purpose of this study was to investigate the relevant factors of pain after transvaginal mesh (TVM) surgery for the treatment of pelvic organ prolapse, and to analyze the management and relief of the pain. Methods A retrospective study of a clinical database of patients who underwent TVM surgery was conducted, and pain related aspects were analyzed. Results The incidence of pain after TVM surgery was 2.70% (50/1855), with a median occurrence time of 7.5 months. Pain symptoms mainly involved vagina, perineum, buttocks, groin, inner thighs, and lower abdomen. Greater intraoperative blood loss (OR = 1.284, 95%CI 0.868–2.401) and postoperative anatomic failure (OR = 1.577, 95%CI 0.952–3.104) were analyzed as risk factors with statistical significance. Mesh exposure rate in pain group was 38%, showing a significant difference between groups (P < 0.01). Forty patients underwent non-surgical treatments, with a relief rate of 40.0%; 33 patients were performed surgical treatments, 15 of which underwent partial mesh removal and 18 underwent complete mesh removal, with a relief rate of 84.8%. The total relief rate was 88% within all 50 patients suffering from pain. Conclusions Excessive intraoperative bleeding and postoperative anatomic failure can increase the risk of postoperative pain; mesh exposure, mesh contracture, and mesh position abnormality are also associated. Most patients can get pain relief with proper management, more than half of which may need mesh removal with differing amounts.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Shi ◽  
Ying Zhao ◽  
Qing Hu ◽  
Runqi Gong ◽  
Yitong Yin ◽  
...  

Abstract Background The purpose of this study was to investigate the relevant factors of pain after transvaginal mesh (TVM) surgery for the treatment of pelvic organ prolapse and to analyse the management and relief of the pain. Methods A multicentre retrospective study of a clinical database of patients who underwent TVM surgery was conducted, and pain related aspects were analysed. Results A total of 1855 patients were included in the study. We divided the patients into two groups: pain-free (1805 patients) and pain (50 patients) group. The incidence of pain after TVM surgery was 2.70%, with a median occurrence time of 7.5 months. Pain mainly involved the vagina, perineum, buttocks, groin, inner thighs, and lower abdomen. Excessive intraoperative blood loss (OR = 1.284, 95% CI 0.868–2.401) and postoperative anatomic failure (OR = 1.577, 95% CI 0.952–3.104) were analysed as risk factors with statistical significance. Mesh exposure rate in the pain group was 38%, showing a significant difference between the groups (P < 0.01). Forty patients underwent non-surgical treatment, with a relief rate of 40.0%, 33 patients received surgical treatment, 15 underwent partial mesh removal, and 18 underwent complete mesh removal, with a relief rate of 84.8%. The total relief rate was 88% within all 50 patients suffering from pain. Conclusions Excessive intraoperative bleeding and unsatisfactory postoperative anatomic outcomes can increase the risk of postoperative pain; mesh exposure is also associated with the pain. Most patients can get pain relief with proper management, more than half of whom may need mesh removal with differing approach.


2010 ◽  
Vol 22 (3) ◽  
pp. 307-313 ◽  
Author(s):  
Yuval Kaufman ◽  
Sony Sukhbir Singh ◽  
Haifa Alturki ◽  
Alan Lam

2019 ◽  
Author(s):  
Zeyu Chen ◽  
Wensheng Du ◽  
Haitao Zhu

Abstract To observe the clinical effect and complications of transvaginal mesh (TVM) placement on treating pelvic organ prolapse (POP).Methods From May 2014 to June 2017, 89 patients with moderate to severe pelvic organ prolapse and pelvic floor defect (PFD) had received TVM pelvic reconstruction at our hospital. The operation time, intraoperative blood loss and intraoperative complications of all patients were recorded, and the incidence of postoperative complications was also observed. In addition, the POP-Q was utilized to evaluate the severity of POP in patients before surgery, as well as at 6 weeks, 6 months, 12 months and 24 months after surgery, respectively; besides, the Pelvic Floor Influence Questionnaire-7 (PFIQ-7), Pelvic Floor Dysfunction Inventory 20 (PFDI-20), and Patient Global Impression of Improvement (PGI-I) were adopted to evaluate the quality of life of patients.Results All the 89 cases had successfully completed the surgery, with the operation time of 60.0±13.0 min and the intraoperative blood loss of 57.2±21.9 mL. All patients had no bladder or rectal injury during the surgery. 2 patients displayed asymptomatic recurrence ,10 cases had postoperative fever, while 3 had mesh exposure, and all of them were improved after symptomatic treatment. Upon discharge, the lumbosacral and pubic discomfort, as well as pelvic organ dragging sensation had disappeared in all patients. In the final follow-up, the PFIQ-7 and PFDI-20 scores in the 89 cases were reduced compared with those before surgery (Ps<0.05).Conclusions TVM placement is effective on treating moderate to severe POP, which is associated with a lower complication rate and higher postoperative satisfaction.


2018 ◽  
Vol 12 (10) ◽  
Author(s):  
Mélanie Aubé ◽  
Marilyne Guérin ◽  
Caroline Rhéaume ◽  
Le Mai Tu

Introduction: Due to U.S Food and Drud Administration warnings and class-action lawsuits, the use of transvaginal mesh for pelvic organ prolapse surgery is controversial. We report data from two Canadian centres, focusing on recurrence and reoperation rates, complication rates, and patient satisfaction.Methods: A retrospective medical chart review was performed. Patients were also invited to a long-term followup clinic for a complete questionnaire and gynecological exam. Patients unable to present to clinic for followup had the option to answer the questionnaire via telephone.Results: A total of 334 patients were operated between 2000 and 2013. Median followup was 38 months for questionnaire and 36 months for physical exam. Thirty-seven patients (11.1%) required repeat operation, including 17 for recurrent prolapse and 10 for mesh exposure; 98.8% of patients reported feeling subjectively improved by their prolapse surgery.Conclusions: Midterm results are satisfactory and patient subjective satisfaction is high following transvaginal mesh repair of pelvic organ prolapse.


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