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Outcomes and Characteristics of Patients Undergoing Surgical Management for Mesh Related Complications

Mazloomdoost, Donna, MD; Pauls, Rachel, N., MD; Kleeman, Steven, D., MD; Crisp, Catrina, C., MD, MSc

Female Pelvic Medicine & Reconstructive Surgery: January/February 2018 - Volume 24 - Issue 1 - p 32–38
doi: 10.1097/SPV.0000000000000434
Original Articles

Objective The aims of this study were to describe the characteristics of women presenting with mesh-related complications and evaluate postoperative quality of life, sexual functioning, and patient-perceived outcomes.

Methods This institutional review board–approved study included a retrospective chart review and a cross-sectional follow-up with validated questionnaires. Demographics and medical histories were collected from charts of women treated for mesh-related complaints between 2010 and 2014. Subjects completed follow-up validated questionnaires regarding health, sexual functioning, postoperative symptom improvement/severity, satisfaction, and regret with the decision to pursue treatment.

Results Ninety-three charts were analyzed. Mean subject age was 55 years, median body mass index was 28.7 kg/m2, and median time from mesh placement to presentation was 2.7 years. Forty-nine had midurethral sling mesh only, 30 had prolapse-related mesh, and 14 had both. Forty-two subjects (48.9%) had mesh exposures, 19 involving prolapse-related mesh (52.4% transvaginal and 47.4% sacrocolpopexy). Surgical revisions were most often for exposure and pain. Seventy-five women were reached for follow-up; 71 agreed to participate, 53 (75%) returned the questionnaires. Thirty had sling revision, 22 had prolapse mesh revision, and 1 had both. Questionnaire results revealed no changes in health or sexual function after treatment. Postoperatively, subjects reported symptom improvement, low symptom severity, as well as high satisfaction and low regret with the decision to pursue surgical intervention.

Conclusions Women with mesh complications presented 2 years after initial placement, most often complaining of exposure or pain/dyspareunia. Although no changes in health or sexual functioning were noted postoperatively, participants reported symptom improvement after revision and satisfaction with the decision to pursue treatment.

Patients with mesh complications most commonly present with pain/dyspareunia; the majority have symptom improvement after removal.

From the Division of Urogynecology, Department of Obstetrics and Gynecology, TriHealth Good Samaritan Hospital, Cincinnati, OH.

Reprints: Donna Mazloomdoost, MD, 3219 Clifton Ave, MOB Suite 101, Cincinnati, OH 45220. E-mail: donnamaz9@gmail.com.

Author contributions: D.M.: protocol development, data collection, analysis, and manuscript writing; R.N.P.: protocol development, analysis, and manuscript editing. S.D.K.: protocol development. C.C.C.: protocol development, analysis, and manuscript editing.

The study was funded through a grant from the Good Samaritan Medical Education Research Fund. The source did not have any input on study design, data collection, analysis, or manuscript submission.

The findings were presented as 2 posters. The first was presented at the 14th AUGS/IUGA Annual Meeting poster presentation; July 21 to 26, 2014; Washington, DC. The other was presented at the 42nd Annual Scientific Meeting of the Society of Gynecologic Surgeons, Palm Springs, CA; April 10 to 13, 2016.

The authors declare that they have nothing to disclose.

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