Pathological findings in explanted vaginal mesh

Li Li, Xiaoyuan Wang, Ji Young Park, Hao Chen, Yiying Wang, Wenxin - Zheng

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

In light of the legal issues and the shortage of data on histopathological findings, we summarized our experience on how explanted vaginal mesh specimens were managed in a surgical pathology practice during the last 5 years. Clinical history and pathology reports were collected from 155 women undergoing transvaginal tape excision. The degree of chronic inflammation, fibrosis, foreign-body giant cell reactions, the number of capillary vessels and nerve fibers, and the presence or absence of adipose tissue were recorded. Among the 155 patients, 65 (41.9%) were active medicolegal cases, with a significant increase in recent years. The main medical indications for mesh excision were pelvic pain, mesh erosion, voiding dysfunction, genital organ prolapse, and vaginal bleeding. In most cases, mild to moderate chronic inflammation with a mild degree of foreign-body giant cell reaction and minimal to mild fibrosis were found in explanted mesh specimens. The specimens were well vascularized without any evidence of nerve abnormality. Patient age correlated negatively with vaginal pain (P =.007) but positively with erosion (P =.005). In addition, the presence of adipose tissue within the explanted mesh correlated significantly with pelvic pain (P =.016). Overall, there was good tissue integration in all specimens. Considering the significant increase in the number of lawsuits in recent years, we recommend that all explanted vaginal mesh specimens be examined microscopically as well as grossly. A list of microscopic findings, including the presence or absence of adipose tissue, is suggested.

Original languageEnglish (US)
Pages (from-to)46-54
Number of pages9
JournalHuman Pathology
Volume69
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Fingerprint

Foreign Body Giant Cells
Adipose Tissue
Pelvic Pain
Fibrosis
Inflammation
Surgical Pathology
Clinical Pathology
Genitalia
Uterine Hemorrhage
Prolapse
Nerve Fibers
Cell Count
Pain

Keywords

  • Explant
  • Mesh erosion
  • Pathology
  • Stress urinary incontinence
  • Vaginal mesh
  • Vaginal pain

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Pathological findings in explanted vaginal mesh. / Li, Li; Wang, Xiaoyuan; Park, Ji Young; Chen, Hao; Wang, Yiying; Zheng, Wenxin -.

In: Human Pathology, Vol. 69, 01.11.2017, p. 46-54.

Research output: Contribution to journalArticle

Li, Li ; Wang, Xiaoyuan ; Park, Ji Young ; Chen, Hao ; Wang, Yiying ; Zheng, Wenxin -. / Pathological findings in explanted vaginal mesh. In: Human Pathology. 2017 ; Vol. 69. pp. 46-54.
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