title: Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To explore the risk factors for mesh erosion after female pelvic floor reconstructive surgery based on published literature.
  
  
  METHODS
  A systematic literature search of the PubMed, Embase, Cochrane Library, Chinese Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI) and Chinese Science and Technology Periodical (VIP) databases was performed to identify studies related to the risk factors for mesh erosion after female pelvic floor reconstruction published before December 2014. Summary unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of associations between the factors and mesh erosion.
  
  
  RESULTS
  In all, 25 studies containing 7,084 patients were included in our systematic review and meta-analysis. Statistically significant differences in mesh erosion after female pelvic floor reconstruction were found in older vs younger patients (OR 0.96, 95% CI 0.94-0.98), more parities vs less parities (OR 1.27, 95% CI 1.07-1.51), the presence of premenopausal/oestrogen replacement therapy (ERT) (OR 1.36, 95% CI 1.03-1.79), diabetes mellitus (OR 1.87, 95% CI 1.35-2.57), smoking (OR 2.35, 95% CI 1.80-3.08), concomitant pelvic organ prolapse (POP) surgery (OR 0.37, 95% CI 0.16-0.84), concomitant hysterectomy (OR 1.46, 95% CI 1.03-2.07), preservation of the uterus at surgery (OR 0.22, 95% CI 0.08-0.63), and surgery performed by senior vs junior surgeons (OR 0.42, 95% CI 0.30-0.58).
  
  
  CONCLUSIONS
  Our study indicates that younger age, more parities, premenopausal/ERT, diabetes mellitus, smoking, concomitant hysterectomy, and surgery performed by a junior surgeon were significant risk factors for mesh erosion after female pelvic floor reconstructive surgery. Moreover, concomitant POP surgery and preservation of the uterus may be the potential protective factors for mesh erosion.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Tuo
authors.initials: T
authors.lastname: Deng
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Banghua
authors.initials: B
authors.lastname: Liao
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Deyi
authors.initials: D
authors.lastname: Luo
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Kunjie
authors.initials: K
authors.lastname: Wang
mesh_terms: D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017773:Pelvic Floor / Q000473:pathology / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012720:Severity of Illness Index; D013526:Surgical Mesh / Q000009:adverse effects*
keywords: female pelvic floor reconstruction; mesh erosion; meta-analysis; risk factors; systematic review