title: Outcome of transvaginal mesh and tape removed for pain only.
abstract: OBJECTIVE
  Because there is reluctance to operate for pain, we evaluated midterm outcomes of vaginal mesh and synthetic suburethral tape removed for pain as the only indication.
  
  
  METHODS
  After receiving institutional review board approval we reviewed a prospective database of women without a neurogenic condition who underwent surgery for vaginal mesh or suburethral tape removal with a focus on pain as the single reason for removal and a minimum 6-month followup. The primary outcome was pain level assessed by a visual analog scale (range 0 to 10) at baseline and at each subsequent visit with the score at the last visit used for analysis. Parameters evaluated included demographics, mean time to presentation and type of mesh or tape inserted.
  
  
  RESULTS
  From 2005 to 2013, 123 patients underwent surgical removal of mesh (69) and suburethral tape (54) with pain as the only indication. Mean followup was 35 months (range 6 to 59) in the tape group and 22 months (range 6 to 47) in the mesh group. The visual analog scale score decreased from a mean preoperative level of 7.9 to 0.9 postoperatively (p = 0.0014) in the mesh group and from 5.3 to 1.5 (p = 0.00074) in the tape group. Pain-free status, considered a score of 0, was achieved in 81% of tape and 67% of mesh cases, respectively. No statistically significant difference was found between the groups.
  
  
  CONCLUSIONS
  When pain is the only indication for suburethral tape or vaginal mesh removal, a significant decrease in the pain score can be durably expected after removal in most patients at midterm followup.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
authors.forename: Jack C
authors.initials: JC
authors.lastname: Hou
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
authors.forename: Feras
authors.initials: F
authors.lastname: Alhalabi
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
authors.forename: Gary E
authors.initials: GE
authors.lastname: Lemack
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas. Electronic address: Philippe.Zimmern@UTSouthwestern.edu.
authors.forename: Philippe E
authors.initials: PE
authors.lastname: Zimmern
mesh_terms: D000328:Adult; D000368:Aged; D020878:Device Removal; D005260:Female; D006801:Humans; D008875:Middle Aged; D017699:Pelvic Pain / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh; D016896:Treatment Outcome; D014621:Vagina
keywords: device removal; pelvic pain; suburethral slings; surgical mesh; urethra