Sarah Kanji1, Dante Pascali2,3, Aisling A Clancy4,5. 1. Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, ON, Canada. 2. Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, The Ottawa Hospital, Ottawa, ON, Canada. 3. University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. 4. Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, The Ottawa Hospital, Ottawa, ON, Canada. aclancy@toh.ca. 5. University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. aclancy@toh.ca.
Abstract
INTRODUCTION AND HYPOTHESIS: Accumulating evidence regarding the negative long-term consequences of transvaginal mesh-based procedures for pelvic organ prolapse has led to a sharp decline in mesh-based procedures. We aimed to evaluate the short-term complications of mesh-based procedures for carefully selected patients with pelvic organ prolapse after Food and Drug Administration warnings. METHODS: A retrospective database review of the ACS NSQIP database was completed to examine 30-day complications including re-operation, prolonged length of stay, blood transfusion, surgical site infection, urinary tract infection, readmission and wound dehiscence in mesh-augmented and native tissue-based transvaginal procedures for pelvic organ prolapse. RESULTS: A total of 36,234 patients were included in the analysis, with only 7.1% (2574 women) having mesh-augmented repair. Using a multivariable logistical regression analysis adjusting for confounders, we found that the primary composite outcome (re-operation, hospital stay, blood transfusion and surgical site infection) was less common in the mesh group compared with the native tissue repair group (adjusted OR 0.80, CI 0.67-0.95, p = 0.009). The secondary outcomes (urinary tract infection, re-admission and wound dehiscence) were not different between the group. CONCLUSION: These results suggest that in well-chosen patients, short-term complications are not increased when using transvaginal mesh for pelvic organ prolapse repair.
INTRODUCTION AND HYPOTHESIS: Accumulating evidence regarding the negative long-term consequences of transvaginal mesh-based procedures for pelvic organ prolapse has led to a sharp decline in mesh-based procedures. We aimed to evaluate the short-term complications of mesh-based procedures for carefully selected patients with pelvic organ prolapse after Food and Drug Administration warnings. METHODS: A retrospective database review of the ACS NSQIP database was completed to examine 30-day complications including re-operation, prolonged length of stay, blood transfusion, surgical site infection, urinary tract infection, readmission and wound dehiscence in mesh-augmented and native tissue-based transvaginal procedures for pelvic organ prolapse. RESULTS: A total of 36,234 patients were included in the analysis, with only 7.1% (2574 women) having mesh-augmented repair. Using a multivariable logistical regression analysis adjusting for confounders, we found that the primary composite outcome (re-operation, hospital stay, blood transfusion and surgical site infection) was less common in the mesh group compared with the native tissue repair group (adjusted OR 0.80, CI 0.67-0.95, p = 0.009). The secondary outcomes (urinary tract infection, re-admission and wound dehiscence) were not different between the group. CONCLUSION: These results suggest that in well-chosen patients, short-term complications are not increased when using transvaginal mesh for pelvic organ prolapse repair.
Authors: Peter S Finamore; Karolynn T Echols; Krystal Hunter; Howard B Goldstein; Adam S Holzberg; Babak Vakili Journal: Int Urogynecol J Date: 2009-12-04 Impact factor: 2.894
Authors: Sophie Warembourg; Majd Labaki; Renaud de Tayrac; Pierre Costa; Brigitte Fatton Journal: Int Urogynecol J Date: 2017-02-01 Impact factor: 2.894
Authors: Isabelle Le Teuff; Majd Labaki; Pascale Fabbro-Peray; Philippe Debodinance; Bernard Jacquetin; Jean Marty; Vincent Letouzey; Georges Eglin; Renaud de Tayrac Journal: J Gynecol Obstet Hum Reprod Date: 2019-05-09