In:
Urologia Internationalis, S. Karger AG, Vol. 86, No. 4 ( 2011), p. 419-423
Abstract:
〈 i 〉 Objective: 〈 /i 〉 To report conservative and surgical strategies for treatment of mesh erosion after pelvic organ prolapse (POP) repair. 〈 i 〉 Methods: 〈 /i 〉 Between 1998 and 2008, 179 patients underwent integral pelvic floor reconstruction for advanced POP in our tertiary urogynecological unit. Patients’ charts and follow-up data were entered into a computerized database and data analysis performed to search for mesh erosion/complications/surgery. 〈 i 〉 Results: 〈 /i 〉 12 patients were diagnosed and treated for mesh erosion: in 10 of 179, surgery was performed in our department and the mesh used was polypropylene (PP): 3 after colposacropexy (CSP) (5.5%), 5 after CSP + hysterectomy (Hys) (6.5%), and 2 after hysterosacropexy (HSP) (3.9%); in 1 case, Gore-tex mesh was used, and another case had undergone CSP in another hospital using PP mesh. Time to mesh erosion ranged from 2 to 66 months (mean 22.9), with 4 erosions (33%) within 6 months of POP repair. In 4 asymptomatic patients (33%) erosion was incidentally discovered during clinical check-ups at 4, 31, 36 and 66 months. Five cases (41%) presented with occasional vaginal bleeding, associated with dyspareunia in 2. Treatments were individualized but in all cases conservative treatment was unable to resolve the complications and surgery was needed. At a mean follow-up of 57 months (range 18–120) after surgical treatment all patients were asymptomatic and free from erosions. 〈 i 〉 Conclusions: 〈 /i 〉 The surgeon who approaches management of complications after abdominal/laparoscopic sacropexy should possess a comprehensive understanding of pelvic floor anatomy and surgical skills in order to individualize the management of such complications.
Type of Medium:
Online Resource
ISSN:
0042-1138
,
1423-0399
Language:
English
Publisher:
S. Karger AG
Publication Date:
2011
detail.hit.zdb_id:
1464417-4
