“…Previous studies have highlighted the risk factors for mesh extrusion, including DM, hypertension, smoking, previous pelvic surgeries, concomitant hysterectomy, greater intraoperative blood loss, and surgery performed by a junior surgeon, with the protective factors being uterine preservation, with no mesh over the apex [16−19]. Although our concomitant hysterectomy rate was high at 63.9%, studies carried out by the same first author using various mesh kits with similarly high hysterectomy rates (67%−92%) have demonstrated that preoperative optimization of medical comorbidities, patient selection, reduction of mesh material, surgeon experience, and surgical technique-rather than concomitant hysterectomy-are the major factors for mesh exposure [16,20,21]. These measures, including tight requirements on preoperative glycated hemoglobin, exclusion of patients with previous radical pelvic surgeries, removal of the 2 middle arms with no mesh placed over the apex or posterior compartment, all surgeries performed by the same senior author (TSL) with a meticulous surgical technique, and minimizing intraoperative blood loss, were similarly employed in our current study.…”