E-Posters-Long-term Clinical Outcome of Simple Excision of Eroded Mesh with Vaginal Estrogen after Urogynecologic Surgery

Long-term Clinical Outcome of Simple Excision of Eroded Mesh with Vaginal Estrogen after Urogynecologic Surgery - Yun Jin Park

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This study investigated the long-term clinical outcome of simple excision of eroded mesh with vaginal estrogen for patients who experienced mesh erosion after urogynecologic surgery. The study reviewed the medical records of patients who underwent the excision of eroded mesh in an outpatient clinic without anesthesia at Yonsei University Hospital. The subjects had mucosal defects of mesh erosion smaller than 0.5 cm. Vaginal estrogen was applied after the mesh excision, and pelvic examinations were conducted within three months after the procedure. <br /><br />A total of 13 patients underwent the excision of eroded mesh with local estrogen, with two patients excluded due to lost follow-up. The mean age at diagnosis of mesh erosion was 55, and the mean parity was 2. Most patients (63.6%) were postmenopausal, and the mean BMI was 24.6. All patients had symptoms related to mesh erosion, such as vaginal discharge, bleeding, and dyspareunia. <br /><br />The initial operations causing mesh erosion were abdominal sacrocolpopexy (n=6) and midurethral sling (n=5). The mean time from the initial surgery to mesh erosion was 40 months, and the mean length of the follow-up period was 51 months. Patients were diagnosed with complete remission (CR) at an average of 101 days after the diagnosis of mesh erosion. During the follow-up period, six patients (54.5%) experienced a recurrence of mesh erosion. The mean time to diagnosis of CR to relapse was 39 months. However, all patients with recurrence were also diagnosed with CR after excision of mesh and vaginal estrogen. None of the patients required further intervention or surgery to treat mesh extrusion, and the complication rate of the excision procedure was 0% during the follow-up period. <br /><br />In conclusion, simple excision of eroded mesh with vaginal estrogen is a safe and less invasive procedure for managing small-sized vaginal mesh erosion. It is an effective alternative to surgery under general anesthesia and can provide complete remission in patients with mesh erosion.

Keywords

long-term clinical outcome

simple excision

eroded mesh

vaginal estrogen

urogynecologic surgery

mesh erosion

pelvic examinations

follow-up period

remission

recurrence