PD32-02 LONG-TERM OUTCOMES AND COMPLICATIONS OF TRANSVAGINAL MESH REMOVAL

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse (PD32)1 Sep 2021PD32-02 LONG-TERM OUTCOMES AND COMPLICATIONS OF TRANSVAGINAL MESH REMOVAL Colby Souders, Andre Miranda, Fatou Sahor, Ramy Goueli, Gary Lemack, Philippe Zimmern, and Maude Carmel Colby SoudersColby Souders More articles by this author , Andre MirandaAndre Miranda More articles by this author , Fatou SahorFatou Sahor More articles by this author , Ramy GoueliRamy Goueli More articles by this author , Gary LemackGary Lemack More articles by this author , Philippe ZimmernPhilippe Zimmern More articles by this author , and Maude CarmelMaude Carmel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002033.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although the use of transvaginal mesh (TVM) had decreased significantly before its ban in April 2019, FPMRS specialists are still treating TVM complications and performing vaginal or open/robotic vaginal mesh removals (VMR) for mesh-related complications. We assessed long-term outcomes and complications of VMR at a tertiary care institution. METHODS: Following Institutional Review Board approval, a retrospective review of non-neurogenic women undergoing transvaginal and abdominal/robotic VMR with 6 months minimum follow-up was undertaken. Mid-urethral sling removals alone were not included. Using an electronic medical record, and a neutral reviewer not directly involved in the care of these women, data abstracted included demographics, provider notes, operative reports, imaging, outside medical records, peri-operative information, and follow-up to the last clinic visit. RESULTS: From 2006 to 2020, 111 patients met study criteria. Table 1 summarizes patient demographics. Presenting symptoms were pain for 71%, dyspareunia for 65%, mesh erosion in 71% and, finally, 4% of patients had mesh perforation into surrounding organs (bladder, rectum, urethra). 42% of patients had a prior VMR at an outside institution. VMR involved an anterior (60%), posterior (11%), anterior and posterior (10%) compartment vaginal mesh and sacrocolpopexy mesh (19%). 38% of patients required a concomitant sling excision. Two ureteral injuries and one rectal injury were repaired intraoperatively. One unrecognized rectal injury required readmission. Mean follow-up was 48 months (range of 6-138 months). Prolapse repair after VMR was needed in 11%, with 6% requiring a subsequent anti-incontinence procedure. VMR resulted in resolution of pain in 64% of patients and resolution of dyspareunia in 47% of patients. CONCLUSIONS: VMR complexity requires advanced surgical expertise. It may result in multiple surgeries, and has an unpredictable functional outcome for pain relief, sexual function, and/or continence/prolapse status. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e544-e545 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Colby Souders More articles by this author Andre Miranda More articles by this author Fatou Sahor More articles by this author Ramy Goueli More articles by this author Gary Lemack More articles by this author Philippe Zimmern More articles by this author Maude Carmel More articles by this author Expand All Advertisement Loading ...