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Defining Patients Knowledge and Perceptions of Vaginal Mesh Surgery

Brown, Lindsay K. MD*; Fenner, Dee E. MD; Berger, Mitchell B. MD, PhD; DeLancey, John O.L. MD; Morgan, Daniel M. MD; Patel, Divya A. PhD; Schimpf, Megan O. MD

Female Pelvic Medicine & Reconstructive Surgery: September/October 2013 - Volume 19 - Issue 5 - p 282–287
doi: 10.1097/SPV.0b013e31829ff765
Original Articles

Objective: Given recent government investigations and media coverage of the controversy regarding mesh surgery, we sought to define patients’ knowledge and perceptions of vaginal mesh surgery.

Study Design: An anonymous survey was distributed to a convenience sample of new patients at urogynecology and female urology clinics at a single medical center during April to June 2012. The survey assessed patients’ demographics, information sources, and beliefs and concerns regarding mesh surgery. The Fisher’s exact test was used to identify predictors of patients’ beliefs regarding mesh. Logistic and linear regressions were used to identify predictors of aversion to surgery and higher concern regarding future surgery.

Results: One hundred sixty-four women completed the survey; 62.2% (102/164) indicated knowledge of mesh surgery for prolapse and/or incontinence and were included in subsequent analyses. The mean ± SD age was 58.0 ± 12.5 years, and 24.5% reported prior mesh surgery. The most common information source was television commercials (57.8%); only 23.5% of the women reported receiving information from a medical professional. Participants indicated the following regarding vaginal mesh: class-action lawsuit in progress (55/102 [54.0%]), causes pain (47/102 [47.1%]), possibility of rejection (35/102 [34.3%]), can cause bleeding and become exposed vaginally (30/102 [29.4%]), and should be removed owing to recall (28/102 [27.5%]). Of these women, 22.1% (19/86) indicated they would not consider mesh surgery. On multivariable logistic regression, level of concern, information from friends/family, and knowledge of class-action lawsuit predicted aversion to mesh surgery.

Conclusion: Nearly two thirds of new patients had knowledge of vaginal mesh surgery. We identified considerable misinformation and aversion to future mesh surgery among these women.

Nearly two thirds of patients presenting for urogynecologic care had prior knowledge of vaginal mesh surgery, and some of this information was erroneous.

From the *Department of Obstetrics and Gynecology, †Division of Gynecology, Urogynecology, Department of Obstetrics and Gynecology, and ‡Division of Gynecology, Program on Women’s Health Care Effectiveness Research (PWHER), Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.

Reprints: Megan O. Schimpf, MD, Department of Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109. E-mail: mschimpf@med.umich.edu.

The authors have declared they have no conflicts of interest.

No financial support was received for this work.

This study was conducted in Ann Arbor, MI.

This work was presented as an oral poster presentation at the Society of Gynecologic Surgeons’ 39th Annual Scientific Meeting, Charleston, SC, April 8–10, 2013.

© 2013 by Lippincott Williams & Wilkins