Managing mesh erosion after abdominal pelvic organ prolapse repair: ten years' experience in a single center.

Abstract:

OBJECTIVE:To report conservative and surgical strategies for treatment of mesh erosion after pelvic organ prolapse (POP) repair. METHODS:Between 1998 and 2008, 179 patients underwent integral pelvic floor reconstruction for advanced POP in our tertiary urogynecological unit. Patients' charts and follow-up data were entered into a computerized database and data analysis performed to search for mesh erosion/complications/surgery. RESULTS:12 patients were diagnosed and treated for mesh erosion: in 10 of 179, surgery was performed in our department and the mesh used was polypropylene (PP): 3 after colposacropexy (CSP) (5.5%), 5 after CSP + hysterectomy (Hys) (6.5%), and 2 after hysterosacropexy (HSP) (3.9%); in 1 case, Gore-tex mesh was used, and another case had undergone CSP in another hospital using PP mesh. Time to mesh erosion ranged from 2 to 66 months (mean 22.9), with 4 erosions (33%) within 6 months of POP repair. In 4 asymptomatic patients (33%) erosion was incidentally discovered during clinical check-ups at 4, 31, 36 and 66 months. Five cases (41%) presented with occasional vaginal bleeding, associated with dyspareunia in 2. Treatments were individualized but in all cases conservative treatment was unable to resolve the complications and surgery was needed. At a mean follow-up of 57 months (range 18-120) after surgical treatment all patients were asymptomatic and free from erosions. CONCLUSIONS:The surgeon who approaches management of complications after abdominal/laparoscopic sacropexy should possess a comprehensive understanding of pelvic floor anatomy and surgical skills in order to individualize the management of such complications.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Costantini E,Zucchi A,Lazzeri M,Del Zingaro M,Vianello A,Porena M

doi

10.1159/000324243

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

419-23

issue

4

eissn

0042-1138

issn

1423-0399

pii

000324243

journal_volume

86

pub_type

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