A Multi-center Registry Study: The Follow-up the Complications for Trans-vaginal Mesh Surgery

2019 ◽  
Author(s):  
Keyword(s):  
Vaginal Mesh ◽  
Registry Study ◽  
Mesh Surgery ◽  
Trans Vaginal Mesh

Long-term observation on postoperative recurrence and complications of transvaginal mesh surgery for pelvic organ prolapse

2021 ◽  
Author(s):  
Junfang Yang ◽  
Kun Zhang ◽  
Jinsong Han ◽  
Yiting Wang ◽  
Ying Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Protective Factor ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Transvaginal Mesh ◽  
Mesh Exposure ◽  
Mesh Surgery ◽  
Post Menopause

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.

scholarly journals Amniotic Membrane Graft in the Management of Complex Vaginal Mesh Erosion

2020 ◽  
Vol 9 (2) ◽  
pp. 356
Author(s):  
Hui-Hsuan Lau ◽  
Quan-Bin Jou ◽  
Wen-Chu Huang ◽  
Tsung-Hsien Su
Keyword(s):  
Amniotic Membrane ◽  
Intraoperative Complications ◽  
Mesh Erosion ◽  
Surgical Revision ◽  
Vaginal Mesh ◽  
Management Options ◽  
Mesh Surgery ◽  
Amniotic Graft ◽  
Vaginal Erosions

Vaginal mesh erosion is a devastating complication after pelvic floor mesh surgery and it can be treated conservatively or with surgical revision. However, the management options following a failed primary revision or complex vaginal erosions are very limited. The aim of this study is to describe a novel treatment using an amniotic membrane as an inlay graft for such patients. Eight patients who failed conservative or primary surgical revision were enrolled. The complex erosions included vaginal agglutination, multiple vaginal erosions, recurrent erosions, and mesh cutting through the urethra. We used an amniotic membrane as a graft to cover the vaginal defect after partial excision of the mesh erosion and we describe the technique in this study. There were no intraoperative complications and none of the patients reported any further symptoms at a mean of 27 months follow-up. Only one patient had recurrent erosion, however, the erosion size was narrower and was subsequently successfully repaired. No further vaginal mesh erosions were noted in the other patients who all had good functional recovery. The use of an amniotic graft can be an economic and alternative method in the management of complex vaginal mesh erosions.

scholarly journals Vaginal mesh surgery is efficient to treat pelvic organ prolapse grade 3 in elderly women

2019 ◽  
Vol 4 (4) ◽  
pp. 38-46
Author(s):  
O. S. Korotkevich ◽  
V. G. Mozes ◽  
I. A. Eizenakh ◽  
A. V. Soloviev ◽  
V. V. Vlasova
Keyword(s):  
Surgical Treatment ◽  
Pelvic Organ Prolapse ◽  
Outcome Measure ◽  
Elderly Women ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Mesh Surgery ◽  
Grade 3

Aim. To evaluate the surgical treatment of pelvic organ prolapse grade 3 in elderly women.Materials and Methods. We consecutively recruited 86 elderly women (60 to 75 years old) suffering from pelvic organ prolapse grade 3. Out of them, 56 patients underwent vaginal mesh surgery while 30 refused surgical treatment. After 1 year, we assessed stress urinary incontinence using a cough test and Valsalva maneuver. Pain intensity was measured using the Numeric Rating Scale whereas quality of life was assessed by Pelvic Floor Disability Index (PDFI-20). The primary outcome measure was the prevalence of pelvic organ prolapse symptoms while the secondary outcome measure was the frequency of stress urinary incontinence and low quality of life upon 1 year of follow-up.Results. After 1 year of follow-up, patients who received a surgical treatment were characterized by a statistically significant decrease in both frequency and intensity of complaints and symptoms of pelvic organ prolapse. Pelvic Organ Prolapse Distress Inventory score was 8.3 (4.2-12.5) and 79.2 (79.2-100) in patients with or without surgical treatment respectively. Similar results were showed using Colorectal-Anal Distress Inventory score (6.2 (3.1-6.2) and 68.8 (62.5-71.9) and Urinary Distress Inventory score (8.3 (4.2-8.3) and 83.3 (79.2-87.5), in treated and untreated individuals, respectively. Total Pelvic Floor Disability Index score was 22.8 (11.5-27.0) in women who underwent a vaginal mesh surgery and 227.2 (226.1251.0) in those who did not. All indicated differences were statistically significant.Conclusions. Vaginal mesh surgery is efficient for the treatment of pelvic organ prolapse grade 3 in elderly women.

scholarly journals Hüvelyi hálóműtétek gyakorlata az amerikai korlátozó figyelmeztetés után. Merjem, vagy ne merjem?

2018 ◽  
Vol 159 (10) ◽  
pp. 397-404 ◽  
Author(s):  
Zoltán Fekete ◽  
Szilvia Körösi ◽  
Gábor Németh
Keyword(s):  
The Elderly ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Referral Centre ◽  
Tertiary Referral Centre ◽  
Mesh Surgery ◽  
Operative Complications ◽  
Short And Long Term

Abstract: Introduction: The prevalence of pelvic organ prolapse (POP) with aging is escalating alarmingly, and now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh (TVM) has been employed with increasing popularity in the treatment of POP until the end of the last decade. After the U.S. Drug and Food Administration (FDA) warnings in the years 2008 and 2011, the number of vaginal mesh operations has decreased dramatically. Aim: The aim of the study was to evaluate and compare the anti-POP effectivity, the anti-stress incontinence (anti-SUI) efficacy, and the late (36 months) post-operative complications of the anterior vaginoplasty and the TVM operations. Method: We analysed the clinical data from 120 patients with stage II–III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2013 and January 2014. Sixty patients underwent Kelly–Stoeckel vaginoplasty and the other 60 cases had TVM operation. The surgical complications were classified using the Clavien–Dindo (CD) classification system. Results: The anti-POP (91.6% vs. 63.3%; p<0.001) and the anti-SUI efficacy (90% vs. 55%, p<0.001) were significantly higher in the TVM group than in the vaginoplasty group, while the overall extrusion rate was found 8.3% after a 3-year follow-up. The Clavien–Dindo score (CD) proved that the early post-operative complication profile was similar among the TVM patients as compared to the vaginoplasty group (p = 0.405). Conclusion: Vaginal mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications. Orv Hetil. 2018; 159(10): 397–404.

Graft Failure, Revision ACLR, and Reoperation Rates After ACLR With Quadriceps Tendon Versus Hamstring Tendon Autografts: A Registry Study With Review of 475 Patients

2021 ◽  
pp. 036354652110151
Author(s):  
Malte Schmücker ◽  
Jørgen Haraszuk ◽  
Per Hölmich ◽  
Kristoffer W. Barfod
Keyword(s):  
Graft Failure ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Quadriceps Tendon ◽  
Hamstring Tendon ◽  
Significant Trend ◽  
Meniscal Injury ◽  
Registry Study ◽  
Cyclops Lesion

Background: It has been indicated that anterior cruciate ligament reconstruction (ACLR) with a quadriceps tendon (QT) graft has a higher risk of revision compared with ACLR performed with a hamstring tendon (HT) graft. Purpose/Hypothesis: To investigate whether ACLR with QT graft had a higher risk of graft failure, revision ACLR, or reoperation compared with HT graft in a high-volume center. We hypothesized that there would be no between-group differences. Study Design: Cohort study; Level of evidence, 3. Methods: This was a registry study with review of medical records. Our study cohort consisted of patients who underwent primary ACLR with either QT or HT graft performed at Copenhagen University Hospital Hvidovre between January 2015 and December 2018. The cohort was identified from the Danish Knee Ligament Reconstruction Registry and linked to the Danish National Patient Registry to identify all hospital contacts after ACLR. The outcome variables were graft failure (rerupture or >3-mm side-to-side difference in anteroposterior [AP] laxity), revision ACLR, reoperation due to cyclops lesion, reoperation due to meniscal injury, and reoperation due to any reason. AP laxity and pivot shift were assessed at 1 year. Kaplan-Meier estimates were used to evaluate the rates of events at 2 years, and comparison was performed with Cox regression analysis. Results: A total of 475 patients (252 HT, 223 QT) were included. The rate of graft failure at 2 years was 9.4% for the QT group and 11.1% for the HT group ( P = .46). For the QT and HT groups, respectively, the rate of revision ACLR was 2.3% and 1.6% ( P = .60), the rate of reoperation due to cyclops lesion was 5.0% and 2.4% ( P = .13), and the rate of reoperation due to meniscal injury was 4.3% and 7.1% ( P = .16). The rate of reoperation due to any reason was 20.5% and 23.6% ( P = .37). At 1-year follow-up, AP laxity was 1.4 mm for QT and 1.5 mm for HT ( P = .51), and the proportion of patients with a positive pivot shift was 29-30% for both groups. Conclusion: QT and HT grafts yielded similar rates of graft failure, revision ACLR, and reoperation at 2 years of follow-up after ACLR. Graft failure was found in 9% to 11% of patients. Patients with QT ACLR showed a non–statistically significant trend of higher risk for reoperation due to cyclops lesion, and those with HT showed a non–statistically significant trend of higher risk for reoperation due to meniscal injury.

scholarly journals PHARMACOINVASIVE VERSUS THROMBOLYSIS IN STEMI COHORT – OUTCOMES FROM A TERTIARY CARE CENTRE OF NORTH INDIA

2020 ◽  
pp. 1-3
Author(s):  
Richa Sharma ◽  
Ajeet Jain ◽  
Praveen Singh ◽  
Bhushan Shah
Keyword(s):  
Myocardial Ischemia ◽  
Tertiary Care ◽  
Myocardial Necrosis ◽  
North India ◽  
Registry Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Promising Strategy ◽  
Cardiology Department

STEMI is an event where transmural myocardial ischemia induces myocardial necrosis. PI strategy is a promising strategy in the management of STEMI. It is prospective registry study conducted in Cardiology Department, KGMU between January-June 2016 to know 30 day outcome of thrombolysis alone or thrombolysis followed by PCI in north India.At 30 day follow up, patients undergoing PI strategy,complained less of angina and dyspnea compared to thrombolysis arm.

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