Salima Ismail1, Emmanuel Chartier-Kastler2,3, Christine Reus2, Jérémy Cohen2,3, Thomas Seisen2,3, Véronique Phé2,3. 1. Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Université, Paris, France. ismail.salima@gmail.com. 2. Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Université, Paris, France. 3. Medical School Sorbonne Université, Paris, France.
Abstract
INTRODUCTION AND HYPOTHESIS: Synthetic tapes and meshes used for the treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can lead to complications that require additional surgical procedures. The objective of this study was to report the functional outcomes following tape/mesh removal procedures. METHODS: This retrospective study included all consecutive women who underwent a tape/mesh surgical revision in a single tertiary referral center from January 2008 to September 2016. Descriptive statistics were performed to assess outcomes. RESULTS: Overall 140 women, with a mean age of 60.5 (range 35-91) years, had a tape/mesh surgical revision. Patients underwent the following surgeries: tape removal (n = 95/140, 67.9%), tape division (n = 23/140, 16.4%), mesh removal (n = 18/140, 12.9%) and concomitant tape and mesh removal (n = 4/140, 2.9%). Tape removals were mainly performed for voiding symptoms (n = 34/95, 35.8%) and vaginal erosion/extrusion (n = 16/95, 16.8%). Most mesh removals were performed for vaginal erosion/extrusion (n = 9/18, 50.0%). Mean interval between tape/mesh insertion and its surgical revision was 52.1 months (range 5.0 days-16.0 years). Mean follow-up time was 20.4 months (range 6.0 days-7.8 years). Voiding and storage symptoms resolved completely in 37/59 (62.7%) patients and in 14/37 (37.8%) patients, respectively; 42/81 (51.9%) patients with postoperative SUI recurrence or persistence underwent an additional surgical procedure. Among the 18 patients who had a mesh removal, only 1 (5.6%) had POP recurrence. CONCLUSION: Although most symptoms resolved after tape and mesh surgical revisions, patients must be informed that symptoms may persist. Recurrent or persistent SUI or POP may require a subsequent surgical procedure.
INTRODUCTION AND HYPOTHESIS: Synthetic tapes and meshes used for the treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can lead to complications that require additional surgical procedures. The objective of this study was to report the functional outcomes following tape/mesh removal procedures. METHODS: This retrospective study included all consecutive women who underwent a tape/mesh surgical revision in a single tertiary referral center from January 2008 to September 2016. Descriptive statistics were performed to assess outcomes. RESULTS: Overall 140 women, with a mean age of 60.5 (range 35-91) years, had a tape/mesh surgical revision. Patients underwent the following surgeries: tape removal (n = 95/140, 67.9%), tape division (n = 23/140, 16.4%), mesh removal (n = 18/140, 12.9%) and concomitant tape and mesh removal (n = 4/140, 2.9%). Tape removals were mainly performed for voiding symptoms (n = 34/95, 35.8%) and vaginal erosion/extrusion (n = 16/95, 16.8%). Most mesh removals were performed for vaginal erosion/extrusion (n = 9/18, 50.0%). Mean interval between tape/mesh insertion and its surgical revision was 52.1 months (range 5.0 days-16.0 years). Mean follow-up time was 20.4 months (range 6.0 days-7.8 years). Voiding and storage symptoms resolved completely in 37/59 (62.7%) patients and in 14/37 (37.8%) patients, respectively; 42/81 (51.9%) patients with postoperative SUI recurrence or persistence underwent an additional surgical procedure. Among the 18 patients who had a mesh removal, only 1 (5.6%) had POP recurrence. CONCLUSION: Although most symptoms resolved after tape and mesh surgical revisions, patients must be informed that symptoms may persist. Recurrent or persistent SUI or POP may require a subsequent surgical procedure.
Authors: Sara Abbott; Cecile A Unger; Janelle M Evans; Karl Jallad; Kevita Mishra; Mickey M Karram; Cheryl B Iglesia; Charles R Rardin; Matthew D Barber Journal: Am J Obstet Gynecol Date: 2013-10-11 Impact factor: 8.661
Authors: Jill M Danford; David J Osborn; W Stuart Reynolds; Daniel H Biller; Roger R Dmochowski Journal: Int Urogynecol J Date: 2014-07-11 Impact factor: 2.894