EP.TU.734Rectal mesh erosion post pelvic gynaecological surgery: A literature review

Abstract

Abstract Introduction Surgical mesh has long been used for the repair of pelvic organ prolapse. In recent years high rates of serious complications have been reported and the US has withdrawn it from use, while the UK advises extreme caution. Here, we present a review of the literature with a focus on causative factors. Methods Twenty-three articles were included in the review: 21 cases of rectal mesh erosion and three cases of sigmoid mesh erosion. Causative factors were subdivided into patient-related, mesh-related and procedure-related. Results Main patient related risk factors included pre-existing intestinal diseases (reported in 4 cases) and an older age (median 65.5). Risk factors that were mesh related included increased porosity. 11 cases were reported with a macroporous (>75µm) mesh, whereas only 1 case had used a microporous (<10µM) mesh. 9 cases with partial/ no details of the mesh. The main risk factor that was procedure related was concomitant hysterectomy with 7 cases of mesh erosion had concomitant hysterectomy, 11 cases without concomitant hysterectomy, with a further 5 being unclear. Conclusion Pre-existing bowel disease, mesh type and mechanical factors associated with surgical technique all influenced the risk of mesh erosion into the bowels. A lack of reported information regarding the original surgical mesh and operation hindered the ability to draw conclusions. A step into rectifying this in the future would be the provision of medical device cards directly to the patient detailing the mesh.