Clinical outcomes of mesh exposure/extrusion: presentation, timing and management.
Aust N Z J Obstet Gynaecol
; 55(3): 284-90, 2015 Jun.
Article
en En
| MEDLINE
| ID: mdl-26044791
ABSTRACT
BACKGROUND:
The Food and Drug Administration has recently highlighted an increase in reported complications associated with the use of transvaginal mesh.AIMS:
To describe the clinical outcomes, presentation, timing and management of mesh exposure/extrusion MATERIALS ANDMETHODS:
Retrospective study from December 2006 to March 2012. A total of 40 women had vaginal mesh exposure/extrusion secondary to prior transvaginal mesh (TVM) surgery. Descriptive statistics were used for demographics and pre-operative data. Paired-samples t-test was applied for comparison of pre- and postoperation. A P value of <0.05 was considered statistically significant.RESULTS:
The mesh exposure/extrusion rate was noted to be 2.64% (17/642). Vaginal bleeding in 29 of 40 (72.5%) and hispareunia in 12 of 13 (92.3%) were identified as the most common symptoms for mesh exposure/extrusion. The onset of complications occurred in two peaks between 3 and 4 months and after 1-year of follow-up. Initial conservative treatment was given for 12.5% (5/40) of women, while 87.5% (35/40) had undergone repair for mesh exposure/extrusion (21 outpatient and 14 inpatient cases). Among those who had conservative treatment, 80% (4/5) had persistent mesh exposure.CONCLUSION:
Persistent or new-onset abnormal vaginal bleeding and hispareunia after TVM surgery should be considered as 'red flag' symptoms for mesh exposure/extrusion. Frequent follow-up from the first 3-4 months up to 1 year postoperative may identify complications. Utilisation of mesh excision or trimming as the initial means of treatment may yield a better outcome.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Mallas Quirúrgicas
/
Hemorragia Uterina
/
Dispareunia
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Aust N Z J Obstet Gynaecol
Año:
2015
Tipo del documento:
Article
País de afiliación:
Taiwán