MP33-19 SYMPTOM RESOLUTION AND RECURRENT PROLAPSE RATES FOLLOWING VAGINAL MESH REMOVAL

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse1 Apr 2018MP33-19 SYMPTOM RESOLUTION AND RECURRENT PROLAPSE RATES FOLLOWING VAGINAL MESH REMOVAL Andrew Bergersen, Elinora Price, Michael Callegari, Evan Austin, Odutoyosi Oduyemi, Joel Funk, and Christian Twiss Andrew BergersenAndrew Bergersen More articles by this author , Elinora PriceElinora Price More articles by this author , Michael CallegariMichael Callegari More articles by this author , Evan AustinEvan Austin More articles by this author , Odutoyosi OduyemiOdutoyosi Oduyemi More articles by this author , Joel FunkJoel Funk More articles by this author , and Christian TwissChristian Twiss More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1090AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate overall symptom and pain resolution and recurrent prolapse following pelvic organ prolapse (POP) mesh removal. METHODS This was an IRB-approved, retrospective review of our patients who underwent POP mesh removal from 2009-2016. Factors of interest included mesh type (transvaginal (TV) or sacrocolpopexy (SCC)), complete vs. partial removal, and presenting symptoms. Complete removal was defined as complete excision of all possible mesh from the anterior and posterior paravaginal space including mesh arms. Partial removal included anything less than complete removal. Postoperative pain improvement was categorized as resolved (symptoms resolved and require no further therapy), improved (symptoms less bothersome, may require further therapy), or unresolved (no/minimal improvement and require further management). Recurrent prolapse was also determined. RESULTS 76 mesh removal patients (63 TV, 8 SCC, 5 unknown) were identified with a mean age of 60 and mean follow-up of 20 months. Overall, symptoms prompting mesh removal resolved or improved in 84%, with 54% classified as resolved, 30% improved, 11% unresolved, and 5% lost to follow-up. In the 37 complete removal patients, 54.1% were resolved, 35.1% improved, and 10.8% unresolved compared to 60% resolved, 28.6% improved, and 11.4% unresolved in the 35 partial removal patients (?2=0.36, p=0.84). 32.4% of complete mesh removal patients developed recurrent prolapse, compared to 20.0% after partial mesh removal (p=0.2). Pain/dyspareunia was the indication for removal in 79% (60/76) of patients, and in this subset 53% were resolved, 37% improved, and 10% were unresolved. In the pain subset, there was no significant difference in pain resolution between complete (34 patients) vs partial (26 patients) removal (53% vs. 58% resolved, respectively, ?2=0.4, p=0.82). In the pain subset, 35.3% (12/34) of patients developed recurrent prolapse after complete removal, compared to 15.4%(4/26) after partial removal (?2=2.0, p=0.15). Overall, 21 (27%) patients in the entire cohort required repeat reconstructive procedures after mesh removal. CONCLUSIONS Following removal of vaginal mesh, most patients experienced resolution or improvement in presenting symptoms, including pain. Complete mesh removal was not significantly associated with symptom improvement or recurrent prolapse. Less than one-third of patients undergoing mesh removal required repeat vaginal prolapse surgery. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e435-e436 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrew Bergersen More articles by this author Elinora Price More articles by this author Michael Callegari More articles by this author Evan Austin More articles by this author Odutoyosi Oduyemi More articles by this author Joel Funk More articles by this author Christian Twiss More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...