title: 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.
authors: Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology, University of Perugia, Perugia, Italy. ecostant @ unipg.it
authors: Elisabetta
authors: E
authors: Costantini
authors: Alessandro
authors: A
authors: Zucchi
authors: Massimo
authors: M
authors: Lazzeri
authors: Michele
authors: M
authors: Del Zingaro
authors: Alberto
authors: A
authors: Vianello
authors: Massimo
authors: M
authors: Porena
mesh_terms: D000005:Abdomen / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy; D017773:Pelvic Floor / Q000473:pathology; D056887:Pelvic Organ Prolapse / Q000601:surgery* / Q000628:therapy*; D011126:Polypropylenes / Q000737:chemistry*; D011138:Polytetrafluoroethylene; D013526:Surgical Mesh / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D014465:Ultrasonics; D014563:Urodynamics; D014945:Wound Healing
chemical_list: D011126:Polypropylenes; D011138:Polytetrafluoroethylene