title: Incidence and Risk Factors for Pelvic Pain After Mesh Implant Surgery for the Treatment of Pelvic Floor Disorders.
abstract: Our aim was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation.
  
  
  
  Retrospective study (Canadian Task Force classification II-2).
  
  
  
  Single university hospital.
  
  
  
  Women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor disorders including prolapse and incontinence.
  
  
  
  Telephone interviews to assess pain, sexual function, and general health.
  
  
  
  Pain was measured by the McGill Short-Form Pain Questionnaire for somatic pain, Neuropathic Pain Symptom Inventory for neuropathic pain, Pennebaker Inventory of Limbic Languidness for somatization, and Female Sexual Function Index (FSFI) for sexual health and dyspareunia. General health was assessed with the 12-item Short-Form Health Survey. Among 160 enrolled women, mean time since surgery was 20.8 ± 10.5 months, mean age was 62.1 ± 11.2 years, 93.8% were white, 86.3% were postmenopausal, and 3.1% were tobacco users. Types of mesh included midurethral sling for stress incontinence (78.8%), abdominal/robotic sacrocolpopexy (35.7%), transvaginal for prolapse (6.3%), and perirectal for fecal incontinence (1.9%), with 23.8% concomitant mesh implants for both prolapse and incontinence. Our main outcome, self-reported pelvic pain at least 1 year after surgery, was 15.6%. Women reporting pain were younger, with fibromyalgia, worse physical health, higher somatization, and lower surgery satisfaction (all p < .05). Current pelvic pain correlated with early postoperative pelvic pain (p < .001), fibromyalgia (p = .002), worse physical health (p = .003), and somatization (p = .003). Sexual function was suboptimal (mean FSFI, 16.2 ± 12.1). Only 54.0% were sexually active, with 19.0% of those reporting dyspareunia.
  
  
  
  One in 6 women reported de novo pelvic pain after pelvic mesh implant surgery, with decreased sexual function. Risk factors included younger age, fibromyalgia, early postoperative pain, poorer physical health, and somatization. Understanding risk factors for pelvic pain after mesh implantation may improve patient selection.
authors: Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: egeller@med.unc.edu.
authors: Elizabeth J
authors: EJ
authors: Geller
authors: School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Emma
authors: E
authors: Babb
authors: Center for Pain Research and Innovation, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Andrea G
authors: AG
authors: Nackley
authors: Division of Advanced Laparoscopy and Pelvic Pain, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Denniz
authors: D
authors: Zolnoun
mesh_terms: D000367:Age Factors; D005260:Female; D005356:Fibromyalgia / Q000150:complications; D006304:Health Status; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000601:surgery*; D017699:Pelvic Pain / Q000209:etiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013001:Somatoform Disorders / Q000150:complications; D053825:Suburethral Slings; D013526:Surgical Mesh
keywords: Mesh; Pelvic pain; Prolapse; Stress urinary incontinence