Skip Navigation LinksHome > September 2011 - Volume 118 - Issue 3 > Risk Factors for Exposure, Pain, and Dyspareunia After Tensi...
Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e31822ada95
Original Research

Risk Factors for Exposure, Pain, and Dyspareunia After Tension-Free Vaginal Mesh Procedure

Withagen, Mariëlla I. MD; Vierhout, Mark E. MD, PhD; Hendriks, Jan C. PhD; Kluivers, Kirsten B. MD, PhD; Milani, Alfredo L. MD

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OBJECTIVE: To identify possible risk factors for exposure, dyspareunia, and pain after insertion of tension-free vaginal mesh in pelvic organ prolapse surgery.

METHODS: This was a prospective observational cohort study. Consecutive women who underwent surgery with a trocar-guided tension-free vaginal mesh kit were included and evaluated at 6 weeks and at 6 and 12 months after surgery with respect to anatomy and complications. Logistic regression analysis was performed to identify risk factors for exposure, dyspareunia, and pain.

RESULTS: Two hundred ninety-four patients were included. Exposure was found in 34 patients (12%). Smoking and total mesh were risk factors for exposure (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.1–8.7 and OR 3.0, 95% CI 1.2–7.0, respectively). Clinical and surgical experience were inversely related to the risk of exposure (OR 0.5, 95% CI 0.3–0.8 per decade). Pain (OR 3.2, 95% CI 1.2–8.4) and dyspareunia (OR 4.7, 95% CI 1.7–12.8) before surgery were predictive for pain and dyspareunia after surgery, respectively. Pain after surgery was found in 35 out of 275 (13%) patients and dyspareunia was found in 77 out of 171 (45%) patients.

CONCLUSION: Smoking, total tension-free vaginal mesh, and experience were predictive factors for mesh exposure.


© 2011 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.



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