Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center.
OBJECTIVE
The use of mesh in pelvic organ prolapse (POP) surgery has become a widespread treatment option, but carries a risk of specific complications. The objective was to report the rate and type of reoperation for mesh-related complications after pelvic organ prolapse surgery in an urogynecological referral center over a period of 8 years.


METHODS
A retrospective study was carried out including all patients operated for a mesh complication after prolapse surgery between September 2006 and September 2014 in the urogynecology unit in Nîmes hospital.


RESULTS
Sixty-nine mesh complications were recorded among the 67 patients included. Surgical treatment of mesh-related complications accounted for 7% of all pelvic surgeries performed in our center. Thirty-two patients (47.8%) were referred from other centers and 35 patients (52.2%) were initially operated in our unit. The global rate of reintervention for mesh-related complications after prolapse repair performed in our unit was 2.8%. Of 69 mesh complications, 48 patients (71.6%) had transvaginal mesh (TVM) and 19 patients (28.4%) sacrocolpopexy (SCP). The indication for surgery was a symptomatic or large vaginal erosion (47.8%), symptomatic mesh contraction (20.3%), and infection (11.6%). The most frequent primary symptom was pelvic/perineal pain or dyspareunia (33.3% of cases). The mean time between initial mesh surgery and the reoperation for a complication was 33.4 months (95% CI, 24.5 to 42.2). Eleven patients (15.9%) required several interventions. In total, 77.9% of patients experienced complete recovery of symptoms after surgical management.


CONCLUSIONS
In a referral center the global rate of reinterventions for mesh-related complications after POP repair is 2.8%. The surgical treatment of mesh complications appears to be a safe and effective procedure with cure of the symptoms in most cases.
Gynecology Department, Urogynecology Unit, Nîmes Hospital, Nîmes, France. sophie.warembourg@chu-nimes.fr.
Sophie
S
Warembourg
Gynecology Department, Urogynecology Unit, Nîmes Hospital, Nîmes, France.
Majd
M
Labaki
Gynecology Department, Urogynecology Unit, Nîmes Hospital, Nîmes, France.
Renaud
R
de Tayrac
Urology Department, Urogynecology Unit, Nîmes Hospital, Nîmes, France.
Pierre
P
Costa
Gynecology Department, Urogynecology Unit, Nîmes Hospital, Nîmes, France.
Brigitte
B
Fatton
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004414:Dyspareunia / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery
Pelvic organ prolapse; Pelvic pain; Post-operative complication; Sacrocolpopexy; Trans-vaginal mesh; Vaginal erosion