Jana D Illston1, Jeffrey B Garris1, Holly E Richter1, Thomas L Wheeler1. 1. From the Greenville Health System, the Department of Obstetrics and Gynecology, University of South Carolina School of Medicine-Greenville, Greenville, and the Department of Obstetrics and Gynecology, University of Alabama at Birmingham.
Abstract
OBJECTIVES: To characterize pain and exposure after Prolift placement and identify risk factors. METHODS: A case series of women who underwent Prolift vaginal mesh were surveyed. Pain was assessed using a visual analog scale. Exposure was evaluated clinically. RESULTS: Of 183 eligible patients, 160 completed the survey, and 45 returned for examination. Mean preoperative pain score was 0.97 and postoperative was 1.35 (P = 0.12). Pre- and postoperative pain scores by compartment were: anterior (1.34 vs 1.25, mean change -0.09, P = 0.84), posterior (1.30 vs 1.56, mean change 0.26, P = 0.72), and total (0.63 vs 1.34, mean change 0.71, P = 0.05). Graft exposure was confirmed in 23 of 183 patients (12.6%); however, because asymptomatic patients were not examined, the true exposure rate may be underestimated. Hematoma formation is independently associated with mesh exposure, adjusted odds ratio 18.4 (95% confidence interval 3.4-147.4, P = 0.01). CONCLUSIONS: Although pain scores did not increase overall, there was a trend toward increased pain score in the patients with total (anterior and posterior) Prolift. Hematoma formation was significantly associated with mesh exposure.
OBJECTIVES: To characterize pain and exposure after Prolift placement and identify risk factors. METHODS: A case series of women who underwent Prolift vaginal mesh were surveyed. Pain was assessed using a visual analog scale. Exposure was evaluated clinically. RESULTS: Of 183 eligible patients, 160 completed the survey, and 45 returned for examination. Mean preoperative pain score was 0.97 and postoperative was 1.35 (P = 0.12). Pre- and postoperative pain scores by compartment were: anterior (1.34 vs 1.25, mean change -0.09, P = 0.84), posterior (1.30 vs 1.56, mean change 0.26, P = 0.72), and total (0.63 vs 1.34, mean change 0.71, P = 0.05). Graft exposure was confirmed in 23 of 183 patients (12.6%); however, because asymptomatic patients were not examined, the true exposure rate may be underestimated. Hematoma formation is independently associated with mesh exposure, adjusted odds ratio 18.4 (95% confidence interval 3.4-147.4, P = 0.01). CONCLUSIONS: Although pain scores did not increase overall, there was a trend toward increased pain score in the patients with total (anterior and posterior) Prolift. Hematoma formation was significantly associated with mesh exposure.
Authors: Dominique El-Khawand; Salim A Wehbe; Peter G O'Hare; Divya Arunachalam; Babak Vakili Journal: Female Pelvic Med Reconstr Surg Date: 2014 Nov-Dec Impact factor: 2.091
Authors: P K Sand; S Koduri; R W Lobel; H A Winkler; J Tomezsko; P J Culligan; R Goldberg Journal: Am J Obstet Gynecol Date: 2001-06 Impact factor: 8.661
Authors: Larry T Sirls; Gregory P McLennan; Kim A Killinger; Judith A Boura; Melissa Fischer; Pradeep Nagaraju; Kenneth Peters Journal: Female Pelvic Med Reconstr Surg Date: 2013 Jul-Aug Impact factor: 2.091
Authors: Cheryl B Iglesia; Andrew I Sokol; Eric R Sokol; Bela I Kudish; Robert E Gutman; Joanna L Peterson; Susan Shott Journal: Obstet Gynecol Date: 2010-08 Impact factor: 7.661
Authors: Jennifer M Wu; Catherine A Matthews; Mitchell M Conover; Virginia Pate; Michele Jonsson Funk Journal: Obstet Gynecol Date: 2014-06 Impact factor: 7.661
Authors: Reijo Hiltunen; Kari Nieminen; Teuvo Takala; Eila Heiskanen; Mauri Merikari; Kirsti Niemi; Pentti K Heinonen Journal: Obstet Gynecol Date: 2007-08 Impact factor: 7.661