title: Long-term follow-up of persistent vaginal polypropylene mesh exposure for transvaginally placed mesh procedures.
abstract: OBJECTIVE
  The surgical treatment of a cystocele via the vaginal route may require the placement of a synthetic mesh below the bladder. However, the placement of a synthetic mesh via the vaginal route can be associated with specific complications, such as vaginal mesh exposure. There is a lack of data concerning the long-term follow-up of asymptomatic persistent vaginal polypropylene mesh exposure.
  
  
  METHODS
  This was a retrospective case series of nine patients presenting with persistent vaginal mesh exposure following the placement of a macroporous monofilament polypropylene mesh for cystocele treatment. Expectant management has been proposed since the patients were asymptomatic.
  
  
  RESULTS
  The median follow-up duration was 121 months [interquartile range (IQR) 119-132]. The median surface area of vaginal mesh exposure (1 cm(2); IQR 1-1) did not change significantly during the follow-up. No pelvic or perineal abscess occurred during the follow-up. Only one of them was sexually active; she complained of dyspareunia at the last follow-up, but refused renewed surgery since she had sexual intercourse on only a small number of occasions per year. Clinical examination using the International Continence Society Pelvic Organ Prolapse Quantification system: Ba -3 to -2 (n = 7; 88 %), Ba -1 (n = 1; 12 %), Ba 0 or greater (n = 0).
  
  
  CONCLUSIONS
  Persistent asymptomatic vaginal polypropylene mesh exposure is associated with few complications at long-term follow-up.
authors.affiliation: Paris-Sud University, Obstetrics-Gynecology and Reproductive Medicine Department, Antoine Beclere Hospital, Public Assistance - Paris Hospitals, AP-HP, Clamart, 92141, France. x.deffieux@free.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Deffieux
authors.forename: Thibault
authors.initials: T
authors.lastname: Thubert
authors.forename: Renaud
authors.initials: R
authors.lastname: de Tayrac
authors.forename: Hervé
authors.initials: H
authors.lastname: Fernandez
authors.forename: Vincent
authors.initials: V
authors.lastname: Letouzey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D052858:Cystocele / Q000601:surgery*; D020878:Device Removal; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011126:Polypropylenes; D015995:Prevalence; D012189:Retrospective Studies; D012725:Sexual Behavior; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*
chemical_list: D011126:Polypropylenes