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

Abstract

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.