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.