E-Posters-10056

10056_Barnes
Pdf Summary
This study aimed to assess the long-term outcomes of vaginal reconstructive surgery with synthetic mesh augmentation. The primary outcome was reoperation for mesh-related complications, and the secondary outcomes included rates of mesh-related complications and overall reoperation rate. The study utilized a retrospective chart review, written survey, and pelvic examination of patients who underwent vaginal surgery for pelvic organ prolapse (POP) with mesh augmentation between 1985 and 2010. <br /><br />The overall reoperation rate was found to be 28%, with common indications for reoperation being mesh-related complications, subsequent POP, and urinary symptoms. Mesh extrusion into the vagina was experienced by 30% of the patients, and only 1% had mesh erosion into the bladder or rectum. Vaginal extrusions were treated with local estrogen, office excision, or surgical excision. The use of synthetic mesh for POP surgical repair started in the 1980s and increased significantly after FDA clearance in 2002. However, in 2008, the FDA issued a warning regarding transvaginal mesh for POP due to severe complications.<br /><br />The study determined that almost one-third of patients who had a mesh-augmented transvaginal repair of prolapse required subsequent surgery, and more than 20% required reoperation for a mesh-related complication. Younger women, those with apical mesh placement, and those who experienced intraoperative urinary tract injury were more likely to undergo reoperation. The study identified factors associated with reoperation for mesh-related complications, such as age, apical mesh placement, and urinary tract injury.<br /><br />In conclusion, this study provides insight into the long-term outcomes following vaginal reconstructive surgery with synthetic mesh augmentation. It highlights the high rates of reoperation for mesh-related complications and the factors that contribute to these complications. These findings can help guide clinicians in decision-making regarding the use of synthetic mesh in POP surgery and inform patients about the potential risks and outcomes. The study was funded by the Department of Obstetrics and Gynecology and Department of Urology at the University of Wisconsin.
Keywords
vaginal reconstructive surgery
synthetic mesh augmentation
long-term outcomes
reoperation
mesh-related complications
mesh extrusion
mesh erosion
pelvic organ prolapse
transvaginal mesh
prolapse surgery