[Risk factors of mesh exposure after transvaginal repair of genital prolapse].
OBJECTIVE
We analysed the risk factors of vaginal surgery of pelvic organ prolapse with non resobable prothesis.


METHODS
This is a continuous, retrospective study of the 208 patients who had surgery between 2003 and 2007. Depending on the localisation of the prolapse, they had a prothesis under the bladder and/or a posterior tape through the sacrospinous ligament. An hysterectomy and a levator myorraphy were done if necessary.


RESULTS
After a 3 years follow-up, we found 16.8% mesh exposure (23% were treated by a conservative way). The highest rate of incidence was at 4 and 10 months. The independent risk factors of exposure were the kind of prothesis, age under 60 and concomitant hysterectomy. Women treated by vaginal estrogens and those operated by the most experienced surgeon had less exposure. We had 5% of complications during the surgery.


CONCLUSIONS
Hysterectomy, kind of prothesis and inverted T colpotomy of Crossen are well known risk factors. Age, stage of prolapse, size of prothesis and surgeon experience are discussed. Vaginal surgery of pelvic organ prolapse with non resobable prothesis must be used only when prolapse stage is higher than 3, hysterectomy has to be avoid and vaginal estrogens must be prescribed.
Guillibert
F
F
Service de gynécologie-obstétrique, CHU de Saint-Etienne, hôpital Nord, 42055 Saint-Etienne cedex 2, France. fguilli@yahoo.fr
Chêne
G
G
Fanget
C
C
Huss
M
M
Seffert
P
P
Chauleur
C
C
D000282:Administration, Intravaginal; D000367:Age Factors; D000368:Aged; D020884:Colpotomy / Q000009:adverse effects*; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D010388:Pelvis; D011183:Postoperative Complications / Q000453:epidemiology*; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013526:Surgical Mesh; D017211:Treatment Failure; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*
D004967:Estrogens