Vaginal Mesh Removal Outcomes: Eight Years of Experience at an Academic Hospital

Olivia O. Cardenas-Trowers, Pouran Malekzadeh, David E. Nix, Kenneth D Hatch

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives The purpose of this study is to describe the clinical history leading up to and the outcomes after vaginal mesh removal surgery at an academic hospital. Methods A retrospective case series of patients who underwent vaginal mesh removal from 2008 to 2015 was conducted. Demographics, clinical history, physical examination, pre- and postoperative symptoms, and number and type of reoperations were abstracted. Results Between February 2008 and November 2015, 83 patients underwent vaginal mesh removal surgery at our hospital. The median time interval from initial mesh placement to removal was 58 months (range, 0.4-154 months). The most common preoperative symptoms were vaginal pain (n = 52, 62%), dyspareunia (n = 46, 55%), and pelvic pain (n = 42, 50%). Intraoperative complications were infrequent (n = 3, 4%). Of patients presenting for follow-up within 4 to 6 weeks postoperatively, the most common symptoms were urinary incontinence (n = 15, 28%), vaginal pain (n = 7, 13%), buttock pain (n = 5, 9%), and urinary tract infection (n = 5, 9%). There were no identifiable risk factors to predict which patients would have persistent postoperative symptoms or who would require more than 1 mesh removal surgery. After vaginal mesh removal, 29 patients (35%) required 1 or more reoperations, with 3 being the highest number of reoperations per patient. The total number of reoperations was 43, with a total of 63 individual procedures performed. Forty-four percent (n = 28) of the procedures were graft removals, 40% (n = 25) were pelvic organ prolapse surgeries (only native tissue repairs), and 16% (n = 10) were stress incontinence surgeries. More than 1 procedure was performed in 49% (n = 21) of the reoperations. Conclusions Vaginal mesh removal surgery is safe; however, some patients require more than 1 procedure, and the risk factors for reoperations are unclear.

Original languageEnglish (US)
Pages (from-to)382-386
Number of pages5
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume23
Issue number6
DOIs
StatePublished - Nov 1 2017

Fingerprint

Reoperation
Pain
Dyspareunia
Pelvic Organ Prolapse
Buttocks
Pelvic Pain
Intraoperative Complications
Urinary Incontinence
Urinary Tract Infections
Physical Examination
Demography
Transplants

Keywords

  • mesh adverse events
  • mesh complications
  • mesh removal surgery
  • mesh surgical outcomes
  • vaginal mesh

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology
  • Urology

Cite this

Vaginal Mesh Removal Outcomes : Eight Years of Experience at an Academic Hospital. / Cardenas-Trowers, Olivia O.; Malekzadeh, Pouran; Nix, David E.; Hatch, Kenneth D.

In: Female Pelvic Medicine and Reconstructive Surgery, Vol. 23, No. 6, 01.11.2017, p. 382-386.

Research output: Contribution to journalArticle

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abstract = "Objectives The purpose of this study is to describe the clinical history leading up to and the outcomes after vaginal mesh removal surgery at an academic hospital. Methods A retrospective case series of patients who underwent vaginal mesh removal from 2008 to 2015 was conducted. Demographics, clinical history, physical examination, pre- and postoperative symptoms, and number and type of reoperations were abstracted. Results Between February 2008 and November 2015, 83 patients underwent vaginal mesh removal surgery at our hospital. The median time interval from initial mesh placement to removal was 58 months (range, 0.4-154 months). The most common preoperative symptoms were vaginal pain (n = 52, 62{\%}), dyspareunia (n = 46, 55{\%}), and pelvic pain (n = 42, 50{\%}). Intraoperative complications were infrequent (n = 3, 4{\%}). Of patients presenting for follow-up within 4 to 6 weeks postoperatively, the most common symptoms were urinary incontinence (n = 15, 28{\%}), vaginal pain (n = 7, 13{\%}), buttock pain (n = 5, 9{\%}), and urinary tract infection (n = 5, 9{\%}). There were no identifiable risk factors to predict which patients would have persistent postoperative symptoms or who would require more than 1 mesh removal surgery. After vaginal mesh removal, 29 patients (35{\%}) required 1 or more reoperations, with 3 being the highest number of reoperations per patient. The total number of reoperations was 43, with a total of 63 individual procedures performed. Forty-four percent (n = 28) of the procedures were graft removals, 40{\%} (n = 25) were pelvic organ prolapse surgeries (only native tissue repairs), and 16{\%} (n = 10) were stress incontinence surgeries. More than 1 procedure was performed in 49{\%} (n = 21) of the reoperations. Conclusions Vaginal mesh removal surgery is safe; however, some patients require more than 1 procedure, and the risk factors for reoperations are unclear.",
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