Postoperative Outcomes Following Tension-Free Vaginal Mesh Surgery for Pelvic Organ Prolapse: A Retrospective Study
Vol. 16 No. 06 (2019),
24 December 2019
Purpose: We retrospectively reviewed the postoperative outcomes of patients who underwent tension-free vaginal mesh (TVM) surgery in our institution.
Methods: In total, 195 TVM surgeries were performed at the Shimane University School of Medicine from January 2010 to May 2016 in patients with Pelvic Organ Prolapse–Quantification (POP-Q) stage II or higher. Perioperative complications and problems arising following surgery were assessed from medical charts.
Results: Among the 195 patients, only 1 patient required blood transfusion due to massive intraoperative blood loss. None of the patients experienced intraoperative complications, such as injury to the bladder or rectum during surgery. Mesh exposure was observed in 10 patients (5.1%). Overall, 6 of these 10 patients were asymptomatic, and surgical treatment was required in only 1 patient. Mesh exposure occurred at significantly higher frequencies in patients aged less than 60 years. Postoperative recurrence of POP, which was defined as recurrence over POP-Q stage 2, was noted in 13 of the 195 patients (6.6%). Re-operation was performed in 1 patient in whom recurrence was observed within 3 months postoperatively. Recurrence of POP was likely to occur in patients with higher POP-Q stages. Overall, 31 of the 195 patients (15.9%) required medication for postoperative stress urinary incontinence (SUI) after surgery. Among these, 2 patients underwent surgical treatment for SUI.
Conclusion: Outcomes following the TVM procedure were satisfactory. However, caution should be exercised
against mesh exposure in younger patients and recurrence of POP in patients with advanced POP-Q stage.
Debodinance P, Berrocal J, Clave H, et al. [Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh]. J Gynecol Obstet Biol Reprod (Paris). 2004;33:577-88.
Abed H, Rahn DD, Lowenstein L, et al. Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Int Urogynecol J. 2011;22:789-98.
Kanasaki H, Oride A, Mitsuo T, Miyazaki K. Occurrence of pre- and postoperative stress urinary incontinence in 105 patients who underwent tension-free vaginal mesh surgery for pelvic organ prolapse: a retrospective study. ISRN Obstet Gynecol. 2014;2014:643495.
Costantini E, Lazzeri M. What part does mesh play in urogenital prolapse management today? Curr Opin Urol. 2015;25:300-4.
Collinet P, Belot F, Debodinance P, Ha Duc E, Lucot JP, Cosson M. Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17:315-20.
Takahashi S, Obinata D, Sakuma T, et al. Tension-free vaginal mesh procedure for pelvic organ prolapse: a single-center experience of 310 cases with 1-year follow up. Int J Urol. 2010;17:353-8.
Falagas ME, Velakoulis S, Iavazzo C, Athanasiou S. Mesh-related infections after pelvic organ prolapse repair surgery. Eur J Obstet Gynecol Reprod Biol. 2007;134:147-56.
Niu K, Lu YX, Shen WJ, Zhang YH, Wang WY. Risk Factors for Mesh Exposure after Transvaginal Mesh Surgery. Chin Med J (Engl). 2016;129:1795-9.
Achtari C, Hiscock R, O'Reilly BA, Schierlitz L, Dwyer PL. Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene/polyglactin 910 (Vypro II) mesh. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16:389-94.
Kaufman Y, Singh SS, Alturki H, Lam A. Age and sexual activity are risk factors for mesh exposure following transvaginal mesh repair. Int Urogynecol J. 2011;22:307-13.
Kim J, Lucioni A, Govier F, Kobashi K. Worse long-term surgical outcomes in elderly patients undergoing SPARC retropubic midurethral sling placement. BJU Int. 2011;108:708-12.
Caquant F, Collinet P, Debodinance P, et al. Safety of Trans Vaginal Mesh procedure: retrospective study of 684 patients. J Obstet Gynaecol Res. 2008;34:449-56.
Sho T, Yoshimura K, Hachisuga T. Retrospective study of tension-free vaginal mesh operation outcomes for prognosis improvement. J Obstet Gynaecol Res. 2014;40:1759-63.
Stanford E, Moen M. Patient safety communication from the Food and Drug Administration regarding transvaginal mesh for pelvic organ prolapse surgery. J Minim Invasive Gynecol. 2011;18:689-91.
Morling JR, McAllister DA, Agur W, et al. Adverse events after first, single, mesh and non-mesh surgical procedures for stress urinary incontinence and pelvic organ prolapse in Scotland, 1997-2016: a population-based cohort study. Lancet. 2017;389:629-40.
Glazener CM, Breeman S, Elders A, et al. Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT). Lancet. 2017;389:381-92.
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