Abstract
Objectives
To report 12-year experience with replacing transvaginal mesh (TVM) with fascia lata autograft.
Methods
This was a chart review of TVM removal and replacement with a fascia lata autograft placement by a single surgeon between 2005 and 2017. The Pelvic Organ Prolapse Quantification (POP-Q) system before and 1 year following the procedure, patient-reported recurrence of symptoms, changes in the POP-Q examination and complication rates are analyzed.
Results
Twenty-four patients were included. Mean age was 57.2 (95% CI 53.2–61.2) years. Mean number of days to Foley catheter removal was 3.2 days (95% CI 1.6–4.9) and mean number of days to drain removal was 10.9 days (95% CI 9.9–12.0). Following the surgery, no leg seroma, infection or numbness was reported. UTI occurred in four (16.7%) of the participants postoperatively. At 3-month follow-up, mild urinary symptoms were reported in five participants (20.8%). At 1-year follow-up, one participant was symptomatic of pelvic organ prolapse. Paired t-test analysis revealed statistically significant retraction of Aa and Ba vaginal points (p < 0.001). C, GH and PB points were also statistically significantly retracted.
Conclusion
Fascia lata autograft for anterior compartment reconstruction due to TVM complications is associated with high safety and efficacy rates.
This is a preview of subscription content, log in via an institution to check access.
References
Cheng Y, Su T, Wang H, Huang W, Lau H. Risk factors and management of vaginal mesh erosion after pelvic organ prolapse surgery. Taiwan Association of Obstetrics & Gynecology. 2017;56:184–7.
Crosby EC, Abernethy M, Berger MB, DeLancey JO, Fenner DE, Morgan DM. Symptom resolution after operative management of complications from transvaginal mesh. Obstet Gynecol. 2014;123(1):134–9.
RR Chesson SS, TE Elkins S, Menefee K, McCammon NF, Barksdale PA, RJ Paddock RY. The use of fascia lata graft for correction of severe or recurrent anterior vaginal wall defects. J Pelv Surg. 1999;5(2):96–103.
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–7.
Acknowledgments
Dr. Alshiek was funded by a research scholar grant from the International Continence Society.
The authors received no assistance—directly or indirectly—from any individuals or companies for preparation of this manuscript.
This paper was presented at the Annual AAGL meeting in 2018.
We would like to acknowledge the assistance from the team at INOVA Advanced Surgical Technology and Education Center (ASTEC) and Mr. Larry Walker, the director of the program, for his support of the program.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None.
Disclaimers
All but one of the patients’ in this data set were collected and analyzed while the senior author was a faculty member at the University of Oklahoma Health Sciences Center in Oklahoma City, OK. The author collects the anatomic pictures during various workshops or cadaver teaching at various institutions.
Consent
Written informed consent was obtained from the patient for publication of this video article and any accompanying images.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
(MP4 94,505 kb)
Rights and permissions
About this article
Cite this article
Alshiek, J., Awad, C., Welch, E. et al. Twelve years’ experience with fascia lata autograft to replace complicated anterior vaginal mesh. Int Urogynecol J 30, 1587–1592 (2019). https://doi.org/10.1007/s00192-019-03957-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-019-03957-2