Surgical management of mesh-related complications after prior pelvic floor reconstructive surgery with mesh

✍ Scribed by Myrthe M. Tijdink; Mark E. Vierhout; John P. Heesakkers; Mariëlla I. J. Withagen

• Publisher: Springer
• Year: 2011
• Tongue: English
• Weight: 182 KB
• Volume: 22
• Category: Article
• ISSN: 0937-3462
• DOI: 10.1007/s00192-011-1476-2

✦ Synopsis

Introduction and hypothesis

The objective of this study is to evaluate the complications and anatomical and functional outcomes of the surgical treatment of mesh-related complications.

Methods

A retrospective cohort study of patients who underwent complete or partial mesh excision to treat complications after prior mesh-augmented pelvic floor reconstructive surgery was conducted.

Results

Seventy-three patients underwent 30 complete and 51 partial mesh excisions. Intraoperative complications occurred in 4 cases, postoperative complications in 13. Symptom relief was achieved in 92% of patients. Recurrence of pelvic organ prolapse (POP) occurred in 29% of complete and 5% of partial excisions of mesh used in POP surgery. De novo stress urinary incontinence (SUI) occurred in 36% of patients who underwent excision of a suburethral sling.

Conclusions

Mesh excision relieves mesh-related complications effectively, although with a substantial risk of serious complications and recurrence of POP or SUI. More complex excisions should be performed in skilled centers.