RISK FACTORS FOR MESH EXPOSURE AFTERTRANSVAGINAL MESH SURGERY
K. NIU, Y. LU;
Department ofGynaecology and Obstetrics, First Affiliated Hosp. of Chinese PLAGen. H, Beijing, China.
Objective:Mesh exposure after surgery continues to be a clinical challenge forurogynecological surgeons. The purpose of this study was to explorethe risk factors for polypropylene (PP) mesh exposure aftertransvaginal mesh (TVM) surgery.
Methods: This studyincluded 311 patients with advanced pelvic organ prolapse (POP), whounderwent TVM from January 2004 to June 2016 at the First AffiliatedHospital of Chinese PLA General Hospital. Clinical data wereevaluated including patient’s demography, TVM type, concomitantprocedures, operation time, blood loss, postoperative morbidity, andmesh exposure. Mesh exposure was identified through postoperativevaginal examination. Statistical analysis was performed to identifyrisk factors for mesh exposure.
Results: 309 patients wereplaced transvaginal PP meshes, including 292 in the anterior wall and17 in the posterior wall. Concomitant tension‑free vaginal tapewas performed in 108 cases. The mean follow‑up time was 35.1 ±23.6 months. PP mesh exposure was identified in 56 cases (18.1%),with 55 in the anterior wall and 1 in the posterior wall. Significantdifference was found in operating time and concomitant proceduresbetween exposed and nonexposed groups (F = 7.212, P =0.01; F = 4.523, P = 0.032, respectively). Binarylogistic regression revealed that the number of concomitantprocedures and operation time were risk factors for mesh exposure (P= 0.001, P = 0.035).
Conclusions: Concomitantprocedures and increased operating time increase the risk forpostoperative mesh exposure in patients undergoing
TVM surgery forPOP.