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Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center

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Abstract

Introduction and hypothesis

The use of mesh in pelvic organ prolapse (POP) surgery has become a widespread treatment option, but carries a risk of specific complications. The objective was to report the rate and type of reoperation for mesh-related complications after pelvic organ prolapse surgery in an urogynecological referral center over a period of 8 years.

Methods

A retrospective study was carried out including all patients operated for a mesh complication after prolapse surgery between September 2006 and September 2014 in the urogynecology unit in Nîmes hospital.

Results

Sixty-nine mesh complications were recorded among the 67 patients included. Surgical treatment of mesh-related complications accounted for 7% of all pelvic surgeries performed in our center. Thirty-two patients (47.8%) were referred from other centers and 35 patients (52.2%) were initially operated in our unit. The global rate of reintervention for mesh-related complications after prolapse repair performed in our unit was 2.8%. Of 69 mesh complications, 48 patients (71.6%) had transvaginal mesh (TVM) and 19 patients (28.4%) sacrocolpopexy (SCP). The indication for surgery was a symptomatic or large vaginal erosion (47.8%), symptomatic mesh contraction (20.3%), and infection (11.6%). The most frequent primary symptom was pelvic/perineal pain or dyspareunia (33.3% of cases). The mean time between initial mesh surgery and the reoperation for a complication was 33.4 months (95% CI, 24.5 to 42.2). Eleven patients (15.9%) required several interventions. In total, 77.9% of patients experienced complete recovery of symptoms after surgical management.

Conclusion

In a referral center the global rate of reinterventions for mesh-related complications after POP repair is 2.8%. The surgical treatment of mesh complications appears to be a safe and effective procedure with cure of the symptoms in most cases.

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Authors and Affiliations

  1. Gynecology Department, Urogynecology Unit, Nîmes Hospital, Nîmes, France

    Sophie Warembourg, Majd Labaki, Renaud de Tayrac & Brigitte Fatton

  2. Urology Department, Urogynecology Unit, Nîmes Hospital, Nîmes, France

    Pierre Costa

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  1. Sophie Warembourg
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  2. Majd Labaki
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Correspondence to Sophie Warembourg.

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Conflicts of interest

S. Warembourg and M. Labaki declare that they have no conflicts of interest. B. Fatton declares acceptance of paid travel expenses from Boston Scientific and declares being a consultant for Allergan and Astellas. R. de Tayrac declares acceptance of paid travel expenses, payment for research, and being a consultant for Boston Scientific. P. Costa declares acceptance of paid travel expenses and being a consultant for Allergan and Boston Scientific.

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Warembourg, S., Labaki, M., de Tayrac, R. et al. Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center. Int Urogynecol J 28, 1139–1151 (2017). https://doi.org/10.1007/s00192-016-3256-5

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