Lisa Rogo-Gupta1, Tamara Grisales, Linda Huynh, Larissa V Rodríguez, Shlomo Raz. 1. From the *Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford; †Division of Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of California Los Angeles; ‡David Geffen School of Medicine, University of California Los Angeles; §Division of Pelvic Medicine and Reconstructive Surgery, Institute of Urology, University of Southern California; and ∥Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, University California Los Angeles, Los Angeles, CA.
Abstract
OBJECTIVES: We report our experience with removal of synthetic and biologic implants used in pelvic reconstruction in a tertiary referral center from 2005 to 2012. METHODS: We performed a retrospective cohort study of all consecutive patients who underwent surgical implant removal for treatment of implant-related complications. Symptoms were determined by patient self-assessment including validated questionnaires. One hundred seventy-nine patients completed follow-up. RESULTS: Three hundred six patients underwent removal for exposure or erosion (57%), pain (46%), and urinary symptoms or incontinence (54%). Ninety patients (29%) had previous revision. Eleven percent had pelvic organ prolapse (POP) implants, 48% had sling implants, and 41% had both implants. Mean time from removal to follow-up was 2 years (median, 2 years; range, <1-7).The majority of patients experienced symptom improvement after implant removal. Seventy-eight percent of those with pain reported pain improvement, 9% reported no change, and 14% experienced worsening. Symptom improvement was reported by 79% of those who underwent removal of a POP implant alone, 79% of those who underwent removal of POP and sling implants, and 83% of those who underwent removal of a sling alone. Quality of life was significantly improved after implant removal overall (P < 0.05) for those who underwent removal of POP and slings, and slings alone, but not for those with POP removal only. CONCLUSIONS: Pain is among the most common symptoms reported in women referred to our institution for implant-related complications. In a series of 306 complex patients with a range of implants and symptoms, removal improved implant-related pain in the majority of patients.
OBJECTIVES: We report our experience with removal of synthetic and biologic implants used in pelvic reconstruction in a tertiary referral center from 2005 to 2012. METHODS: We performed a retrospective cohort study of all consecutive patients who underwent surgical implant removal for treatment of implant-related complications. Symptoms were determined by patient self-assessment including validated questionnaires. One hundred seventy-nine patients completed follow-up. RESULTS: Three hundred six patients underwent removal for exposure or erosion (57%), pain (46%), and urinary symptoms or incontinence (54%). Ninety patients (29%) had previous revision. Eleven percent had pelvic organ prolapse (POP) implants, 48% had sling implants, and 41% had both implants. Mean time from removal to follow-up was 2 years (median, 2 years; range, <1-7).The majority of patients experienced symptom improvement after implant removal. Seventy-eight percent of those with pain reported pain improvement, 9% reported no change, and 14% experienced worsening. Symptom improvement was reported by 79% of those who underwent removal of a POP implant alone, 79% of those who underwent removal of POP and sling implants, and 83% of those who underwent removal of a sling alone. Quality of life was significantly improved after implant removal overall (P < 0.05) for those who underwent removal of POP and slings, and slings alone, but not for those with POP removal only. CONCLUSIONS:Pain is among the most common symptoms reported in women referred to our institution for implant-related complications. In a series of 306 complex patients with a range of implants and symptoms, removal improved implant-related pain in the majority of patients.
Authors: Elliot K Blau; Sarah A Adelstein; Katherine A Amin; Sharon J Durfy; Alvaro Lucioni; Kathleen C Kobashi; Una J Lee Journal: Investig Clin Urol Date: 2019-11-15
Authors: Bianca B Mengerink; Nassim Aourag; Kirsten B Kluivers; Kim J B Notten; John P F A Heesakkers; Frank M J Martens Journal: Cent European J Urol Date: 2021-11-18