E-Posters-Pelvic Floor Ultrasound for Mesh Complications: Is there an Association With Symptoms?

Pelvic Floor Ultrasound for Mesh Complications: Is there an Association With Symptoms? - Annika Taithongchai, MRCOG

Pdf Summary

This study aimed to investigate the associations between 2D and 3D pelvic floor ultrasound findings and symptoms in women experiencing complications related to mid-urethral sling (MUS) placement. The use of mesh for pelvic floor dysfunction treatment has been controversial, leading to a pause on its use in the UK. As a result, more patients are presenting with complications from pelvic floor mesh. The optimal mode of investigation for these women is still unknown.<br /><br />The study included women who underwent pelvic floor ultrasound for MUS complications between October 2016 and October 2018. 2D transperineal ultrasound and 3D endovaginal ultrasound were performed using validated methods. Associations were tested between MUS presence, location, morphology, and patient symptoms.<br /><br />The results showed that proximal MUS placement was associated with recurrent stress urinary incontinence. Symptoms of voiding dysfunction were associated with a shorter distance of the mesh to the urethral lumen and a C-to-C shape of the mesh from rest to Valsalva.<br /><br />The researchers concluded that there is an association between MUS placement and morphology using 3D ultrasound with patient symptoms, specifically voiding dysfunction and stress urinary incontinence. However, specific findings correlating with pain were not determined in this study. These findings align with other studies using 3D/4D ultrasound.<br /><br />In total, 311 women underwent ultrasound for suspected mesh-related complications following MUS surgery. 59% of them complained of pain, and one-third reported symptoms starting within 4 weeks of surgery. The study also included visual representations of ultrasound images showing the position and morphology of the mid-urethral sling.<br /><br />The authors disclosed no financial conflicts of interest.

Keywords

pelvic floor ultrasound

2D ultrasound

3D ultrasound

mid-urethral sling

MUS complications

mesh for pelvic floor dysfunction treatment

pelvic floor mesh

voiding dysfunction

stress urinary incontinence

pain in women