Risk factors for mesh complications after trocar guided transvaginal mesh kit repair of anterior vaginal wall prolapse

• Published in: Neurourology and urodynamics Vol. 31; no. 7; pp. 1165 - 1169
• Main Authors: Elmér, Caroline, Falconer, Christian, Hallin, Anders, Larsson, Gregor, Ek, Marion, Altman, Daniel
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.09.2012
• Subjects: Aged; Chi-Square Distribution; Cystocele - surgery; Equipment Design; erosion; Europe - epidemiology; Female; Foreign-Body Reaction - epidemiology; Humans; inflammation; Inflammation - epidemiology; Logistic Models; Medicin och hälsovetenskap; mesh; Middle Aged; Multivariate Analysis; Odds Ratio; Parity; Polypropylenes; Pregnancy; Prevalence; prolapse; Prospective Studies; Risk Assessment; Risk Factors; Smoking - epidemiology; Surgical Mesh - adverse effects; Time Factors; Treatment Outcome; Urologic Surgical Procedures - adverse effects; Urologic Surgical Procedures - instrumentation; Uterine Prolapse - surgery; Europe
• ISSN: 0733-2467; 1520-6777; 1520-6777
• DOI: 10.1002/nau.22231

Aims To identify risk factors for mesh exposures after anterior pelvic organ prolapse repair using a standardized trocar guided polypropylene mesh kit. Methods A secondary risk analysis combining patients from two prospective multicenter studies. Main outcome was clinical host‐vs‐implant reactions one year after surgery using a macroscopic inflammatory scale. Results 353 patients were included in the study. Mean age at surgery was 65.3 (±9.6 SD) years and surgery was performed as a primary procedure in 224/353 (63.5%) patients. Mesh exposures, of which the majority were mild‐moderate, occurred in a total of 30/349 patients (8.6%). Multivariate logistic regression showed increased odds for mesh exposures for women who smoked before surgery (OR 3.48, 95% CI 1.18–10.28), who had given birth to more than two children (OR 2.64, 95% CI 1.07–6.51) and those with somatic inflammatory disease (OR 5.11, 95% CI 1.17–22.23). Age, body mass index, and menopausal status showed no significant association with clinical mesh exposures. Conclusions Smoking, multiple childbirth, and somatic inflammatory disease are possible risk factors for mesh exposure after trocar guided mesh kit surgery for anterior pelvic organ prolapse. Preoperative smoking cessation may decrease the risk for exposures. Neurourol. Urodynam. 31:1165–1169, 2012. © 2012 Wiley Periodicals, Inc.