PD33-12 ANALYSIS OF LUTS AND DYSPAREUNIA IN PATIENTS UNDERGOING TRANSVAGINAL MESH REMOVAL FOR MESH EXPOSURE AND EROSION

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology I1 Apr 2014PD33-12 ANALYSIS OF LUTS AND DYSPAREUNIA IN PATIENTS UNDERGOING TRANSVAGINAL MESH REMOVAL FOR MESH EXPOSURE AND EROSION Lara MacLachlan, Justin Ellett, Kelly Johnson, Gini Ikwuezunma, Michelle Koski, Ross Rames, Ahmed El-Zawahry, and Eric Rovner Lara MacLachlanLara MacLachlan More articles by this author , Justin EllettJustin Ellett More articles by this author , Kelly JohnsonKelly Johnson More articles by this author , Gini IkwuezunmaGini Ikwuezunma More articles by this author , Michelle KoskiMichelle Koski More articles by this author , Ross RamesRoss Rames More articles by this author , Ahmed El-ZawahryAhmed El-Zawahry More articles by this author , and Eric RovnerEric Rovner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2295AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transvaginal mesh has been commonly used in the operative management of stress urinary incontinence (SUI) and pelvic organ prolapse. Vaginal mesh exposure and mesh erosion into the urinary tract is a complication seen with these surgeries. We reviewed our experience with lower urinary tract symptoms (LUTS) and dyspareunia outcomes following mesh explantation over a 7-year period in those patients who underwent surgery for mesh removal. METHODS A retrospective review of patients who underwent explantation of vaginal mesh from 2007 to 2013 was conducted. A total of 191 patients were identified of which 77 patients had evidence of vaginal mesh exposure and/or mesh erosion into the urinary tract. Other indications for mesh explantation included bladder outlet obstruction, pain, and dyspareunia. The following symptoms were evaluated at baseline and at 3 months follow-up: storage symptoms (frequency, urgency and nocturia=SS), voiding symptoms (hesitancy, straining, incomplete emptying and positional voiding=VS), dyspareunia, urge urinary incontinence (UUI), and SUI. RESULTS The most common presenting symptoms for the entire cohort were SS (76.6%) and VS (76.5%). Of the cohort, 53 patients had vaginal mesh exposure, 24 had erosion with 5 having both exposure and erosion. Patients presenting with vaginal mesh exposure did not differ in the array of presenting symptoms as compared with those patients with mesh erosion. The group of patients who had neither mesh exposure nor erosion had a significant improvement of all their symptoms at 3 months (p<0.03). Of the patients with vaginal mesh exposure, there was a statistical improvement in all of their symptoms, with the exception of SUI. The patients with mesh erosion had a significant improvement in VS (p<0.001) and dyspareunia (p=0.008), but no improvement in SS, UUI, or SUI. CONCLUSIONS This study demonstrates improvement in symptoms for those patients undergoing mesh removal surgery who do not have mesh exposure or erosion. However, for those patients with mesh erosion into the urinary tract there is comparatively less success in improving their urinary symptoms. This knowledge can be used in counseling patients with LUTS related to mesh complications prior to surgical mesh removal. No Mesh Exposure or Erosion (n=113) Mesh Exposure (n=53) Mesh Erosion (n=24) Presenting Symptoms: Storage 97 (85.8%) 40 (75.5%) 19 (79.2%) Voiding 78 (69.0%) 21 (39.6%) 11 (45.8%) Dyspareunia 41 (36.3%) 36 (67.9%) 14 (58.3%) UUI 66 (58.4%) 31 (58.5%) 14 (58.3%) SUI 49 (43.4%) 28 (52.8%) 12 (50.0%) 3 Months F/U: Storage 67 (59.3%) 24 (45.3%) 14 (58.3%) Voiding 29 (25.7%) 5 (9.4%) 5 (20.8%) Dyspareunia 12 (10.6%) 8 (15.1%) 6 (25.0%) UUI 45 (39.8%) 17 (32.1%) 15 (62.5%) SUI 49 (43.4%) 28 (52.8%) 12 (50.0%) © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e845 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Lara MacLachlan More articles by this author Justin Ellett More articles by this author Kelly Johnson More articles by this author Gini Ikwuezunma More articles by this author Michelle Koski More articles by this author Ross Rames More articles by this author Ahmed El-Zawahry More articles by this author Eric Rovner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...