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Purely Transvaginal/Perineal Management of Complications From Commercial Prolapse Kits Using a New Prostheses/Grafts Complication Classification System

2012; Lippincott Williams & Wilkins; Volume: 187; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2011.12.066

1527-3792

Farzeen Firoozi, Michael Ingber, Courtenay Moore, Sandip P. Vasavada, Raymond R. Rackley, Howard B. Goldman,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyAdult Urology1 May 2012Purely Transvaginal/Perineal Management of Complications From Commercial Prolapse Kits Using a New Prostheses/Grafts Complication Classification System Farzeen Firoozi, Michael S. Ingber, Courtenay K. Moore, Sandip P. Vasavada, Raymond R. Rackley, and Howard B. Goldman Farzeen FirooziFarzeen Firoozi , Michael S. IngberMichael S. Ingber , Courtenay K. MooreCourtenay K. Moore , Sandip P. VasavadaSandip P. Vasavada , Raymond R. RackleyRaymond R. Rackley , and Howard B. GoldmanHoward B. Goldman View All Author Informationhttps://doi.org/10.1016/j.juro.2011.12.066AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Commercial prolapse mesh kits are increasingly used in the management of pelvic organ prolapse. We present our experience with the transvaginal/perineal management of synthetic mesh related complications from prolapse kits. In addition, we used the new ICS/IUGA (International Continence Society/International Urogynecological Association) prostheses/grafts complication classification system to report on our contemporary series. Materials and Methods: A retrospective chart review of all patients who underwent surgical removal of transvaginal mesh for mesh related complications after prolapse kit use from November 2006 to April 2010 at 1 institution was performed. We report our contemporary series of mesh complications using the new ICS/IUGA prostheses/grafts complication classification system. Postoperative pain, degree of improvement and presence of continued symptoms were reported by patients at last followup. Results: A total of 23 patients underwent transvaginal removal of mesh during the study period. Mean patient age was 61 years. Median period of latency to mesh related complication was 10 months (range 1 to 27). Indications for mesh removal included vaginal/pelvic pain (39%), dyspareunia (39%), vaginal mesh extrusion/exposure (26%), urinary incontinence (35%), recurrent pelvic organ prolapse (22%), bladder mesh perforation with recurrent urinary tract infection (22%), rectal mesh perforation (4%), ureteral perforation injury (4%), retained foreign body (surgical sponge) in the bladder (4%) and vesicovaginal fistula (9%), with most patients citing more than 1 reason. Conclusions: Although technically difficult in some cases, purely transvaginal mesh excision appears to be safe with resolution of almost all presenting symptoms. Although slightly cumbersome, the new ICS/IUGA prostheses/graft complication classification system can be used to report and more accurately characterize mesh complications. References 1 : Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol1997; 89: 501. 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Google Scholar 8 : Retrospective multicentre study of the new minimally invasive mesh repair devices for pelvic organ prolapse. BJOG2008; 115: 22. Google Scholar 9 : One-year anatomic and quality-of-life outcomes after the Prolift procedure for treatment of posthysterectomy prolapse. Am J Obstet Gynecol2008; 199: 694. Google Scholar 10 : Vesicovaginal fistula and mesh erosion after Perigee (transobturator polypropylene mesh anterior repair). Urology2006; 68: 1121. Google Scholar Glickman Urological and Kidney Institute, Center for Female Pelvic Medicine and Reconstructive Surgery, Cleveland Clinic, Cleveland, Ohio© 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byWein A (2018) Re: Management of Complications of Mesh SurgeryJournal of Urology, VOL. 195, NO. 5, (1539-1543), Online publication date: 1-May-2016.Elterman D, Chughtai B, Vertosick E, Maschino A, Eastham J and Sandhu J (2018) Changes in Pelvic Organ Prolapse Surgery in the Last Decade among United States UrologistsJournal of Urology, VOL. 191, NO. 4, (1022-1027), Online publication date: 1-Apr-2014.Roslan M and Markuszewski M (2018) Transvesical Laparoendoscopic Single Site Surgery to Remove Surgical Materials Penetrating the Bladder: Initial Clinical Experience in 9 Female PatientsJournal of Urology, VOL. 190, NO. 3, (909-915), Online publication date: 1-Sep-2013. Volume 187Issue 5May 2012Page: 1674-1679 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordsreconstructive surgical proceduresprolapsesurgical meshpostoperative complicationspelvisMetricsAuthor Information Farzeen Firoozi More articles by this author Michael S. Ingber More articles by this author Courtenay K. Moore Financial interest and/or other relationship with Pfizer and Allergan. More articles by this author Sandip P. Vasavada Financial interest and/or other relationship with AMS and Pfizer. More articles by this author Raymond R. Rackley Financial interest and/or other relationship with Novartis, Pfizer, Astellas, Allergan, NDI Medical and GMD. More articles by this author Howard B. Goldman Financial interest and/or other relationship with Johnson & Johnson, AMS, Pfizer, Astellas, Allergan and IBI Ltd. More articles by this author Expand All Advertisement PDF downloadLoading ...