Incidence and risk factors for mesh erosion after laparoscopic repair of pelvic organ prolapse by lateral suspension with mesh. Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Dällenbach, Patrick; Oliveira, Sara; Marras, Sandra; Boulvain, Michel
• Is Part Of: International urogynecology journal. Volume 27:Issue 9(2016)
• Page Start: 1347
• Page End: 1355
• Publication Date: 2016-09
• Subjects: Nested case–control study -- Pelvic organ prolapse -- Incidence -- Risk factors -- Mesh erosion -- Laparoscopy; Urogynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; 616.60082
• DOI: 10.1007/s00192-016-2974-z
• Languages: English
• ISSNs: 0937-3462

Abstract

Abstract Introduction and hypothesis The objective of our study was to estimate the incidence and identify the risk factors for mesh erosion after laparoscopic repair of pelvic organ prolapse (POP) by lateral suspension with mesh. Methods We conducted a nested case–control study among 480 women who underwent POP repair by laparoscopic lateral suspension with mesh from January 2004 to October 2012. Cases (n = 18) were women who showed mesh erosion following the first intervention through December 2014. Controls (n = 133) were women randomly selected from the same cohort who did not have any erosion. Results The risk of mesh erosion was 3.8 % with a mean follow-up of 82.3 months (range 28.2 – 130.6 months). The main risk factor was the use of a type 3 mesh (macroporous with either multifilamentous or microporous components) rather than a type 1 mesh (macroporous and monofilamentous; adjusted OR 13.0, 95 % CI 1.5 – 110.6;P = 0.02). Risk factors included smoking (adjusted OR 10.4, 95 % CI 2.3 – 46.5;P < 0.01) and posterior mesh placement (adjusted OR 5.1, 95 % CI 1.2 – 21.8P = 0.03). Conclusions The risk of mesh erosion is low and may be further reduced by using the appropriate mesh material, and by identifying specific patient characteristics such as tobacco use. As conventional vaginal surgery is effective for the treatment of the posterior compartment, the use of posterior mesh during laparoscopic pelvic floor repair needs to be questioned.