No Correlation Between Presenting Symptoms Prior to Suburethral Sling Removal and Explanted Pathology Findings Suggests No Need for Routine Microscopic Pathology Evaluation. Issue 1 (21st April 2021)

• Record Type: Journal Article
• Authors: Patel, Rahul S.; Christie, Alana L.; Zimmern, Philippe E.
• Is Part Of: Female pelvic medicine & reconstructive surgery. Volume 28:Issue 1(2022)
• Page Start: 49
• Page End: 53
• Publication Date: 2021-04-21
• Subjects: midurethral sling removal -- pathology findings -- systemic autoimmune inflammatory disorder -- sling complications; Pelvis -- Diseases -- Periodicals; Pelvis -- Surgery -- Periodicals; Genital Diseases, Female -- surgery -- Periodicals; Urologic Diseases -- surgery -- Periodicals; Colonic Diseases -- surgery -- Periodicals; Rectal Diseases -- surgery -- Periodicals; Surgical Procedures, Operative -- methods -- Periodicals; 616.6
• DOI: 10.1097/SPV.0000000000001058
• Languages: English
• ISSNs: 2151-8378

Abstract

Abstract : Objectives: We compared explanted midurethral sling (MUS) standard clinical pathology report findings with presenting symptoms before synthetic sling removal (SSR). Methods: An institutional review board-approved, prospectively maintained database of women who underwent a single SSR for MUS-related complication(s) was retrospectively reviewed for demographics, time interval between MUS placement and SSR, MUS type, and presenting symptoms before SSR. We compared 2 groups, one with MUS-related symptoms, including incontinence, voiding dysfunction, dyspareunia/pain, erosion, exposure, and/or urinary tract infections, and the second group characterized by self-reported symptoms attributed to the mesh material (systemic, autoimmune, or inflammatory disorder—mesh reaction group). Results: From 2005 to 2019, 332 of 473 women met study criteria, with 24 reporting mesh reaction-related symptoms. There was no difference in microscopic pathology findings between the 2 groups. In the mesh-related group, women were younger ( P = 0.041) and had more pain/dyspareunia as their primary SSR indication ( P = 0.002). That group was also significantly more likely to have a preexisting diagnosis of fibromyalgia ( P < 0.001) and established autoimmune disorder ( P = 0.033). No significant correlation between presenting findings and sling pathology was observed. Conclusions: No correlation was observed when comparing pathological findings of explanted MUS with presenting symptoms of MUS-related complications, including in women with mesh reaction-related concerns.