Use of Mesh in Vaginal Pelvic Organ Prolapse Surgery

Hegde, C. V.

doi:10.1007/s13224-011-0065-0

Cited by 1 publication

(1 citation statement)

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“…Mesh placement in our cohort of initial surgeries was most often used in the laparotomy group, and in particular used for reconstructions after extensive oncological resections or endometriosis resections. In daily gynecological practice, meshes are more frequently placed in reoperations and located in the lesser pelvis, as part of surgery for pelvic organ prolapse [ 16 , 17 ]. Organ prolapse surgery is often performed at a higher age and seldom as an initial operation.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Adhesion-Related Readmission and Abdominal Reoperation after Gynecological Surgery: A Nationwide Cohort Study

Toneman

Groenveld

Krielen

et al. 2023

JCM

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More than half of women in developed countries undergo surgery during their lifetime, putting them at risk of adhesion-related complications. Adhesion-related complications include small bowel obstruction, chronic (pelvic) pain, subfertility, and complications associated with adhesiolysis during reoperation. The aim of this study is to predict the risk for adhesion-related readmission and reoperation after gynecological surgery. A Scottish nationwide retrospective cohort study was conducted including all women undergoing a gynecological procedure as their initial abdominal or pelvic operation between 1 June 2009 and 30 June 2011, with a five-year follow-up. Prediction models for two- and five-year risk of adhesion-related readmission and reoperation were constructed and visualized using nomograms. To evaluate the reliability of the created prediction model, internal cross-validation was performed using bootstrap methods. During the study period, 18,452 women were operated on, and 2719 (14.7%) of them were readmitted for reasons possibly related to adhesions. A total of 2679 (14.5%) women underwent reoperation. Risk factors for adhesion-related readmission were younger age, malignancy as indication, intra-abdominal infection, previous radiotherapy, application of a mesh, and concomitant inflammatory bowel disease. Transvaginal surgery was associated with a lower risk of adhesion-related complications as compared to laparoscopic or open surgeries. The prediction model for both readmissions and reoperations had moderate predictive reliability (c-statistics 0.711 and 0.651). This study identified risk factors for adhesion-related morbidity. The constructed prediction models can guide the targeted use of adhesion prevention methods and preoperative patient information in decision-making.

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Section: Discussionmentioning

confidence: 99%