title: Incidence and risk factors for mesh erosion after laparoscopic repair of pelvic organ prolapse by lateral suspension with mesh.
abstract: OBJECTIVE
  The objective of our study was to estimate the incidence and identify the risk factors for mesh erosion after laparoscopic repair of pelvic organ prolapse (POP) by lateral suspension with mesh.
  
  
  METHODS
  We conducted a nested case-control study among 480 women who underwent POP repair by laparoscopic lateral suspension with mesh from January 2004 to October 2012. Cases (n = 18) were women who showed mesh erosion following the first intervention through December 2014. Controls (n = 133) were women randomly selected from the same cohort who did not have any erosion.
  
  
  RESULTS
  The risk of mesh erosion was 3.8 % with a mean follow-up of 82.3 months (range 28.2 - 130.6 months). The main risk factor was the use of a type 3 mesh (macroporous with either multifilamentous or microporous components) rather than a type 1 mesh (macroporous and monofilamentous; adjusted OR 13.0, 95 % CI 1.5 - 110.6; P = 0.02). Risk factors included smoking (adjusted OR 10.4, 95 % CI 2.3 - 46.5; P < 0.01) and posterior mesh placement (adjusted OR 5.1, 95 % CI 1.2 - 21.8 P = 0.03).
  
  
  CONCLUSIONS
  The risk of mesh erosion is low and may be further reduced by using the appropriate mesh material, and by identifying specific patient characteristics such as tobacco use. As conventional vaginal surgery is effective for the treatment of the posterior compartment, the use of posterior mesh during laparoscopic pelvic floor repair needs to be questioned.
authors.affiliation: Department of Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, 30 boulevard de la Cluse, 1211, Genève 14, Switzerland. Patrick.Dallenbach@hcuge.ch.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dällenbach
authors.affiliation: Department of Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, 30 boulevard de la Cluse, 1211, Genève 14, Switzerland.
authors.forename: Sara Sofia
authors.initials: SS
authors.lastname: De Oliveira
authors.affiliation: Department of Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, 30 boulevard de la Cluse, 1211, Genève 14, Switzerland.
authors.forename: Sandra
authors.initials: S
authors.lastname: Marras
authors.affiliation: Department of Gynecology and Obstetrics, Epidemiology and Research in Obstetrics and Gynecology Unit, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Boulvain
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Incidence; Laparoscopy; Mesh erosion; Nested case–control study; Pelvic organ prolapse; Risk factors