Skip to main content

Advertisement

SpringerLink
Log in

Mesh retraction correlates with vaginal pain and overactive bladder symptoms after anterior vaginal mesh repair

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The aim of the present study was to determine possible correlations between mesh retraction after anterior vaginal mesh repair and de novo stress urinary incontinence (SUI), overactive bladder (OAB), and vaginal pain symptoms.

Methods

One hundred and three women with symptomatic prolapse of the anterior vaginal wall, stages 3 and 4 based on the Pelvic Organ Prolapse Quantification (POP-Q) system, underwent Prolift anterior™ implantation. At a 6-month follow-up, the patients were interviewed for de novo SUI, OAB, and vaginal pain, and underwent an introital/transvaginal ultrasound examination to measure the mesh length in the midsagittal plane.

Results

Mesh retraction was significantly larger in a subgroup of patients (n = 20; 19.4 %) presenting de novo OAB symptoms on the follow-up assessment compared with those without this complication (5.0 cm vs. 4.3 cm; p < 0.05). Mesh retraction was also significantly larger in a subgroup of patients (n = 23; 22.3 %) reporting postoperative vaginal pain compared with the women who did not report any postoperative vaginal pain (5.3 cm vs. 4.2 cm; p < 0.01). A significant correlation was found between mesh retraction and the severity of vaginal pain (R = 0.4, p < 0.01). Mesh retraction did not differ between patients with de novo SUI symptoms and those without this complication.

Conclusions

Mesh retraction assessed on ultrasound examination after anterior vaginal mesh repair may correlate with de novo OAB symptoms and vaginal pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ICC:

Intra-correlation coefficient

OAB:

Overactive bladder

POP:

Pelvic organ prolapse

POP-Q:

Pelvic organ prolapse quantification

SUI:

Stress urinary incontinence

References

  1. Foon R, Toozs-Hobson P, Latthe PM (2008) Adjuvant materials in anterior vaginal wall prolapse surgery: a systematic review of effectiveness and complications. Int Urogynecol J Pelvic Floor Dysfunct 19(12):1697–1706

    Article  PubMed  Google Scholar 

  2. Maher CM, Feiner B, Baessler K, Glazener CM (2011) Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J 22(11):1445–1457

    Article  PubMed  Google Scholar 

  3. Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C; Nordic Transvaginal Mesh Group (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364(19):1826–1836

    Article  Google Scholar 

  4. Skala C, Renezeder K, Albrich S, Puhl A, Laterza RM, Naumann G, Koelbl H (2011) The IUGA/ICS classification of complications of prosthesis and graft insertion: a comparative experience in incontinence and prolapse surgery. Int Urogynecol J 22(11):1429–1435

    Article  PubMed  CAS  Google Scholar 

  5. Haylen BT, Freeman RM, Lee J, Swift SE, Cosson M, Deprest J, Dwyer PL, Fatton B, Kocjancic E, Maher C, Petri E, Rizk DE, Schaer GN, Webb R (2012) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related to native tissue female pelvic floor surgery. Int Urogynecol J 23(5):515–526

    Article  PubMed  Google Scholar 

  6. Jelovsek JE, Barber MD (2006) Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol 194(5):1455–1461

    Article  PubMed  Google Scholar 

  7. Gauruder-Burmester A, Koutouzidou P, Rohne J, Gronewold M, Tunn R (2007) Follow-up after polypropylene mesh repair of anterior and posterior compartments in patients with recurrent prolapse. Int Urogynecol J Pelvic Floor Dysfunct 18(9):1059–1064

    Article  PubMed  CAS  Google Scholar 

  8. Tunn R, Picot A, Marschke J, Gauruder-Burmester A (2007) Sonomorphological evaluation of polypropylene mesh implants after vaginal mesh repair in women with cystocele or rectocele. Ultrasound Obstet Gynecol 29(4):449–452

    Article  PubMed  CAS  Google Scholar 

  9. Velemir L, Amblard J, Fatton B, Savary D, Jacquetin B (2010) Transvaginal mesh repair of anterior and posterior vaginal wall prolapse: a clinical and ultrasonographic study. Ultrasound Obstet Gynecol 35(4):474–480

    Article  PubMed  CAS  Google Scholar 

  10. Svabík K, Martan A, Masata J, El-Haddad R, Hubka P, Pavlikova M (2011) Ultrasound appearances after mesh implantation - evidence of mesh contraction or folding? Int Urogynecol J 22(5):529–533

    Article  PubMed  Google Scholar 

  11. Dietz HP, Barry C, Lim YN, Rane A (2005) Two-dimensional and three-dimensional ultrasound imaging of suburethral slings. Ultrasound Obstet Gynecol 26(2):175–179

    Article  PubMed  CAS  Google Scholar 

  12. Dietz HP (2010) Pelvic floor ultrasound: a review. Am J Obstet Gynecol 202(4):321–334

    Article  PubMed  Google Scholar 

  13. Ostergard DR (2010) Polypropylene vaginal mesh grafts in gynecology. Obstet Gynecol 116(4):962–966

    Article  PubMed  Google Scholar 

  14. Caquant F, Collinet P, Debodinance P, Berrocal J, Garbin O, Rosenthal C, Clave H, Villet R, Jacquetin B, Cosson M (2008) Safety of trans vaginal mesh procedure: retrospective study of 684 patients. J Obstet Gynaecol Res 34(4):449–456

    Article  PubMed  Google Scholar 

  15. Letouzey V, Deffieux X, Levaillant JM, Faivre E, de Tayrac R (2009) Ultrasound evaluation of polypropylene mesh contraction at long term after vaginal surgery for cystocele repair. J Minim Invasive Gynecol 16:S46

    Article  Google Scholar 

  16. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21(1):5–26

    Article  PubMed  Google Scholar 

  17. Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17

    Article  PubMed  CAS  Google Scholar 

  18. Debodinance P, Berrocal J, Clavé H, Cosson M, Garbin O, Jacquetin B, Rosenthal C, Salet-Lizée D, Villet R (2004) Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh. J Gynecol Obstet Biol Reprod (Paris) 33(7):577–588

    Article  CAS  Google Scholar 

  19. Simon M, Debodinance P (2011) Vaginal prolapse repair using the Prolift kit: a registry of 100 successive cases. Eur J Obstet Gynecol Reprod Biol 158(1):104–109

    Article  PubMed  Google Scholar 

  20. Stamey TA (1973) Endoscopic suspension of the vesical neck for urinary incontinence. Surg Gynecol Obstet 136:547–554

    PubMed  CAS  Google Scholar 

  21. Foster RT, Barber MD, Parasio MF, Walters MD, Weidner AC, Amundsen CL (2007) A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse. Am J Obstet Gynecol 197(1):82.e1–4

    Article  Google Scholar 

  22. Schäfer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, Sterling AM, Zinner NR, van Kerrebroeck P; International Continence Society (2002) Good urodynamic practices, uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21(3):261–274

    Article  Google Scholar 

  23. Rogowski A, Bienkowski P, Samochowiec J, Mierzejewski P, Jerzak M, Baranowski W (2010) Reliability and clinical validity of a Polish version of the CONTILIFE: a quality of life questionnaire for urinary incontinence. Int Urogynecol J 21(6):731–736

    Article  PubMed  Google Scholar 

  24. Ghoniem G, Stanford E, Kenton K, Achtari C, Goldberg R, Mascarenhas T, Parekh M, Tamussino K, Tosson S, Lose G, Petri E (2008) Evaluation and outcome measures in the treatment of female urinary stress incontinence: International Urogynecological Association (IUGA) guidelines for research and clinical practice. Int Urogynecol J 19(1):5–33

    Article  CAS  Google Scholar 

  25. Visco AG, Brubaker L, Nygaard I, Richter HE, Cundiff G, Fine P, Zyczynski H, Brown MB, Weber AM, Network PFD (2008) The role of preoperative urodynamic testing in stress-continent women undergoing sacrocolpopexy: the Colpopexy and Urinary Reduction Efforts (CARE) randomized surgical trial. Int Urogynecol J Pelvic Floor Dysfunct 19(5):607–614

    Article  PubMed  Google Scholar 

  26. Tunn R, Schaer G, Peschers U, Bader W, Gauruder A, Hanzal E, Koelbl H, Koelle D, Perucchini D, Petri E, Riss P, Schuessler B, Viereck V (2005) Updated recommendations on ultrasonography in urogynecology. Int Urogynecol J Pelvic Floor Dysfunct 16(3):236–241

    Article  PubMed  CAS  Google Scholar 

  27. De Boer TA, Kluivers KB, Withagen MI, Milani AL, Vierhout ME (2010) Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery. Int Urogynecol J 21(9):1143–1149

    Article  PubMed  Google Scholar 

  28. Manodoro S, Endo M, Uvin P, Albersen M, Vláčil J, Engels A, Schmidt B, De Ridder D, Feola A, Deprest J (2013) Graft-related complications and biaxial tensiometry following experimental vaginal implantation of flat mesh of variable dimensions. BJOG 120(2):244–250

    Article  PubMed  CAS  Google Scholar 

  29. Feiner B, Maher C (2010) Vaginal mesh contraction: definition, clinical presentation, and management. Obstet Gynecol 115(2 Pt 1):325–330

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The study was supported by the National Science Center (NCN grant no. NN407098838 to A.R.) and the Institute of Psychiatry and Neurology, Warsaw, Poland (P.B., P.M.).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Gynecology and Oncological Gynecology, Military Institute of Medicine, 128 Szaserow Street, 04-141, Warsaw, Poland

    A. Rogowski, A. Tosiak, M. Jerzak & W. Baranowski

  2. Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland

    P. Bienkowski & P. Mierzejewski

Authors
  1. A. Rogowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Bienkowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Tosiak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Jerzak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Mierzejewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W. Baranowski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Rogowski.

Additional information

Brief summary

The present study suggests that mesh retraction after anterior vaginal wall repair may contribute to bothersome postoperative complications, including de novo overactive bladder symptoms and vaginal pain

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rogowski, A., Bienkowski, P., Tosiak, A. et al. Mesh retraction correlates with vaginal pain and overactive bladder symptoms after anterior vaginal mesh repair. Int Urogynecol J 24, 2087–2092 (2013). https://doi.org/10.1007/s00192-013-2131-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-013-2131-x

Keywords

Search

Navigation