Functional outcomes of synthetic tape and mesh revision surgeries: a monocentric experience

Ismail, Salima; Chartier‐Kastler, Emmanuel; Cohen, Jérémy; Seisen, Thomas; Phé, Véronique

doi:10.1007/s00192-018-3727-y

Cited by 15 publications

(11 citation statements)

References 25 publications

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“…The treatment of mesh exposure secondary to mid-urethral sling operations is partial or total removal of the mesh (16). However, various studies have reported that SUI recurs in approximately 30-60% of patients following the removal of the mesh (17). Jonathan et al (18) reported the results of 102 patients who underwent revision due to mesh erosion.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of concomitant intravaginal laser treatment in patients undergoing mesh excision due to vaginal exposure or extrusion

Sarıkaya

Şenocak

İbiş

et al. 2022

Anatolian Current Medical Journal

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Objective: To investigate the efficacy of intravaginal laser therapy applied concurrently with mesh excision for the treatment of vaginal polypropylene mesh exposure or extrusion, which is the most common complication after transobturator tape (TOT), on the recurrence of incontinence. Material and Method:The data of 49 patients who underwent mesh excision due to vaginal mesh exposure or extrusion in our clinic between January 2009 and January 2020 were retrospectively analyzed. The patients were divided into two groups as simultaneous intravaginal laser therapy during the mesh excision (EL, n=23) and only mesh excision (EO, n=26). Data of the patients and long-term stress urinary incontinence (SUI) recurrence rates were determined and the groups were compared. Results:The mean age of the patients was 50.4±9.9 years and the mean follow-up period was 33.3±22.1 months. SUI recurrence in 1-h pad test was significantly lower in the EL group than the EO group at the 12 th month evaluation (8.7% vs 34.6% p=0.030 respectively). According to multivariate regression analysis operation type was an independent risk factor for SUI recurrence (p=0.021). However, there was no significant difference between the groups in terms of postoperative incontinence quality of life questionnaire (I-QOL) scores (p=0.082). Conclusion:Concomitant laser treatment applied with the mesh excision for the treatment of vaginal meshexposure or extrusion secondary to TOT surgery provides a significant advantage in preventing the recurrence of SUI.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of concomitant intravaginal laser treatment in patients undergoing mesh excision due to vaginal exposure or extrusion

Sarıkaya

Şenocak

İbiş

et al. 2022

Anatolian Current Medical Journal

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“…Some patients may have no symptoms, so a careful vaginal examination is needed after surgery for follow-up. Vaginal tape erosion without other problems can be treated in a conservative way, such as prointravaginal estrogen administration [5,11]. When conservative treatments fail, partial or complete tape removal is recommended [5,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Vaginal tape erosion without other problems can be treated in a conservative way, such as prointravaginal estrogen administration [5,11]. When conservative treatments fail, partial or complete tape removal is recommended [5,11,12]. For the correction of recurrent SUI, retropubic TVT tape is recommended for high priority with encouraging success [13].…”

Section: Discussionmentioning

confidence: 99%

Case report of vaginal erosion and recurrence of stress urinary incontinence due to shallow placement of tension-free vaginal tape

Huang

2022

BMC Urol

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Background Suburethral sling with tension-free vaginal tape (TVT) has become a popular treatment for stress urinary incontinence (SUI). Erosion of the tape into the vaginal is rare. Very few patients present with vaginal tape erosion and recurrence of SUI. Case presentation A 49-year-old female patient with stress urinary incontinence was treated with a retropubic suburethral TVT sling. 2 months later, recurrent symptoms of SUI developed. 6 months later, the patient complained of repeated vaginal discharge and foreign body sensation. Body physical examination revealed a 1-cm-long tape extrusion at the left anterior vaginal wall beside the midline. Cystourethroscopy revealed no urethral mesh erosion. Surgical removal of the extrusion tape revealed that the left arm of the tape was in the vaginal mucosa layer rather than between the whole thickness of the vaginal mucosa and urethral. The tape around the urethral was dissected and removed. A new retropubic tape was placed simultaneously. At the 8-months follow-up after surgery, the patient was continent without tape vaginal exposure. Conclusions Vaginal mesh erosion should be considered in a patient who presents with sustained vaginal discharge after being treated with a suburethral sling. It is important to place the tape between the whole thickness of the vaginal mucosa and the urethral in SUI surgery. A shallow placement of the tape may lead to vaginal tape erosion and recurrence of SUI. These complications can be avoided by following the correct manipulation procedure and referring to the tissue layer anatomy.

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“…Again, there is little guidance to determine the amount of mesh to be excised; among patients with reoperation for MUS-related pain, partial versus complete vaginal excision yielded similar rates of pain resolution (72%-76%) and the rates of SUI (22% for partial, 56% for complete) were not statistically significantly different [15]. It is important for the patient to realize that most data suggest that some degree of pain remains for onequarter to one-half of patients [30][31][32].…”

Section: Pain Associated With Musmentioning

confidence: 99%

Joint position statement on the management of mesh-related complications for the FPMRS specialist

2020

Int Urogynecol J

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The scientific approach to categorizing mesh complications and optimal methods to address them have been complicated by the rapid proliferation and evolution of materials and techniques that have been used over the past 20 years in surgical treatment of pelvic floor disorders. In addition, terminology used to diagnose and categorize mesh complications and the descriptions of surgical procedures to manage them have been adopted inconsistently, further hampering the development of a collective experience with a standardized lexicon. Finally, much of the high-quality data on management of mesh complications is based on materials that are rarely used or not commercially available today.Women experiencing mesh complications need to be heard and should have access to resources and providers who are most able to help. Many women require multiple procedures to address their mesh complications, and for some of these patients, relief is incomplete. We should strive to optimize the treatment at the initial diagnosis of a mesh-related complication.This Position Statement has 4 goals: 1. Using the best and most relevant evidence available, provide guidance for the FPMRS subspecialist caring for patients who may be experiencing mesh complications 2: Provide an algorithm outlining treatment choices for patients with mesh-related complications that can be used as a platform for shared decision making in the treatment of these complications 3: Identify and prioritize gaps in evidence concerning specific mesh complications and their treatments 4: Identify provider and health facility characteristics that may optimize the outcomes of treatments for these complications Keywords pelvic floor disorder . mesh complications Providers caring for women with pelvic floor disorders are aware that surgery has attendant risks that counterbalance the benefits. Decisions concerning the balance of risks and benefits should be made in collaboration with each patient. In recent decades, frustration with surgical failures has prompted development of materials and techniques using synthetic mesh. In some circumstances, these techniques seem to confer durability, but the implants themselves introduce unique risks. The 2011 Update to the Food and Drug Administration's Public Health Notification regarding use of transvaginal mesh (TVM) stated that these complications are not rare and can be difficult to treat. The scientific approach to categorizing mesh complications and optimal methods to address them have been complicated by the rapid proliferation and evolution of materials and techniques that have been used over the past 20 years in surgical treatment of The AAGL endorses this document. The Society of Gynecologic Surgeons supports this document. Individual contributors are noted in the Acknowledgments section. This report is being published concurrently in Female Pelvic Medicine and Reconstructive Surgery and in International Urogynecology Journal. The report is identical except for minor stylistic and spelling differences in keeping with each jou...

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Functional outcomes of synthetic tape and mesh revision surgeries: a monocentric experience

Abstract: Although most symptoms resolved after tape and mesh surgical revisions, patients must be informed that symptoms may persist. Recurrent or persistent SUI or POP may require a subsequent surgical procedure.

Cited by 15 publications

References 25 publications

The effectiveness of concomitant intravaginal laser treatment in patients undergoing mesh excision due to vaginal exposure or extrusion

The effectiveness of concomitant intravaginal laser treatment in patients undergoing mesh excision due to vaginal exposure or extrusion

Case report of vaginal erosion and recurrence of stress urinary incontinence due to shallow placement of tension-free vaginal tape

Joint position statement on the management of mesh-related complications for the FPMRS specialist

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