title: Risk factors for mesh complications after trocar guided transvaginal mesh kit repair of anterior vaginal wall prolapse.
abstract: OBJECTIVE
  To identify risk factors for mesh exposures after anterior pelvic organ prolapse repair using a standardized trocar guided polypropylene mesh kit.
  
  
  METHODS
  A secondary risk analysis combining patients from two prospective multicenter studies. Main outcome was clinical host-vs-implant reactions one year after surgery using a macroscopic inflammatory scale.
  
  
  RESULTS
  353 patients were included in the study. Mean age at surgery was 65.3 (± 9.6 SD) years and surgery was performed as a primary procedure in 224/353 (63.5%) patients. Mesh exposures, of which the majority were mild-moderate, occurred in a total of 30/349 patients (8.6%). Multivariate logistic regression showed increased odds for mesh exposures for women who smoked before surgery (OR 3.48, 95% CI 1.18-10.28), who had given birth to more than two children (OR 2.64, 95% CI 1.07-6.51) and those with somatic inflammatory disease (OR 5.11, 95% CI 1.17-22.23). Age, body mass index, and menopausal status showed no significant association with clinical mesh exposures.
  
  
  CONCLUSIONS
  Smoking, multiple childbirth, and somatic inflammatory disease are possible risk factors for mesh exposure after trocar guided mesh kit surgery for anterior pelvic organ prolapse. Preoperative smoking cessation may decrease the risk for exposures.
authors.affiliation: Division of Surgery and Urology, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden. caroline.elmer@ds.se
authors.forename: Caroline
authors.initials: C
authors.lastname: Elmér
authors.forename: Christian
authors.initials: C
authors.lastname: Falconer
authors.forename: Anders
authors.initials: A
authors.lastname: Hallin
authors.forename: Gregor
authors.initials: G
authors.lastname: Larsson
authors.forename: Marion
authors.initials: M
authors.lastname: Ek
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D052858:Cystocele / Q000601:surgery*; D004867:Equipment Design; D005060:Europe / Q000453:epidemiology; D005260:Female; D005549:Foreign-Body Reaction / Q000453:epidemiology*; D006801:Humans; D007249:Inflammation / Q000453:epidemiology*; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010298:Parity; D011126:Polypropylenes; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013526:Surgical Mesh / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation; D014596:Uterine Prolapse / Q000601:surgery*
chemical_list: D011126:Polypropylenes