De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair.
OBJECTIVE
We sought to determine the rate of de novo stress incontinence, pelvic muscle symptoms, mesh exposure, visceral injury rate, and recurrent prolapse after transvaginal mesh repair.


METHODS
We conducted a retrospective review of 335 consecutive women with stage II or worse vaginal prolapse who underwent Prolift (Ethicon, Somerville, NJ) between July 7, 2005 and Jan. 31, 2008.


RESULTS
In all, 71% underwent total Prolift, 20% anterior, and 8% posterior alone. Average age was 62 years and mean follow-up was 8 months. The intraoperative visceral injury rate was 6.6%, mesh exposure rate was 3.8%, and recurrent failure rate was 5.2%. The postoperative de novo stress incontinence rate was 24.3%. In this series, 18% of women had pelvic muscle symptoms postoperatively; 74% of these resolved within 6 months with conservative management.


CONCLUSIONS
After Prolift, surgeons can expect a low rate of recurrent prolapse and mesh exposure. However, pelvic muscle dysfunction and de novo stress incontinence will be encountered postoperatively in a moderate number of women.
Aungst
Matthew J
MJ
Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Walter Reed Army Medical Center, Washington, DC, USA. Matt.Aungst@yahoo.com
Friedman
Evan B
EB
von Pechmann
Walter S
WS
Horbach
Nicolette S
NS
Welgoss
Jeffrey A
JA
D000328:Adult; D000368:Aged; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D019736:Prostheses and Implants; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000503:physiopathology; D014563:Urodynamics; D014596:Uterine Prolapse / Q000601:surgery*