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Complications after pelvic floor repair surgery (with and without mesh): short-term incidence after 1873 inclusions in the French VIGI-MESH registry.
BJOG ; 127(1): 88-97, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31544327
ABSTRACT

OBJECTIVE:

To assess the short-term incidence of serious complications of surgery for urinary incontinence or pelvic organ prolapse.

DESIGN:

Prospective longitudinal cohort study using a surgical registry.SETTING: Thirteen public hospitals in France.POPULATION: A cohort of 1873 women undergoing surgery between February 2017 and August 2018.

METHODS:

Preliminary analysis of serious complications after a mean follow-up of 7 months (0-18 months), according to type of surgery. Surgeons reported procedures and complications, which were verified by the hospitals' information systems.

MAIN OUTCOME MEASURES:

Serious complication requiring discontinuation of the procedure or subsequent surgical intervention, life-threatening complication requiring resuscitation, or death.

RESULTS:

Fifty-two women (2.8%, 95% CI 2.1-3.6%) experienced a serious complication either during surgery, requiring the discontinuation of the procedure, or during the first months of follow-up, necessitating a subsequent reoperation. One woman also required resuscitation; no women died. Of 811 midurethral slings (MUSs), 11 were removed in part or totally (1.4%, 0.7-2.3%), as were two of 391 transvaginal meshes (0.5%, 0.1-1.6%), and four of 611 laparoscopically placed mesh implants (0.7%, 0.2-1.5%). The incidence of serious complications 6 months after the surgical procedure was estimated to be around 3.5% (2.0-5.0%) after MUS alone, 7.0% (2.8-11.3%) after MUS with prolapse surgery, 1.7% (0.0-3.8%) after vaginal native tissue repair, 2.8% (0.9-4.6%) after transvaginal mesh, and 1.0% (0.1-1.9%) after laparoscopy with mesh.

CONCLUSIONS:

Early serious complications are relatively rare. Monitoring must be continued and expanded to assess the long-term risk associated with mesh use and to identify its risk factors.TWEETABLE ABSTRACT: Short-term serious complications are rare after surgery for urinary incontinence or pelvic organ prolapse, even with mesh.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Telas Cirúrgicas / Diafragma da Pelve / Prolapso de Órgão Pélvico Aspecto clínico: Etiologia / Prognóstico Limite: Adulto / Idoso / Feminino / Humanos / Meia-Idade / Jovem adulto País/Região como assunto: Europa Idioma: Inglês Revista: BJOG Assunto da revista: Ginecologia / Obstetrícia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: França