Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature
Identifieur interne : 000045 ( Pmc/Curation ); précédent : 000044; suivant : 000046Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature
Auteurs : D. Barski [Allemagne] ; D. Y. Deng [États-Unis]Source :
- BioMed Research International [ 2314-6133 ] ; 2015.
Abstract
Url:
DOI: 10.1155/2015/831285
PubMed: 25973425
PubMed Central: 4418012
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature</title>
<author><name sortKey="Barski, D" sort="Barski, D" uniqKey="Barski D" first="D." last="Barski">D. Barski</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, Lukas Hospital, Preussenstrasse 84, 41464 Neuss, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Urology, Lukas Hospital, Preussenstrasse 84, 41464 Neuss</wicri:regionArea>
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<author><name sortKey="Deng, D Y" sort="Deng, D Y" uniqKey="Deng D" first="D. Y." last="Deng">D. Y. Deng</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Urology, University of California, 400 Parnassus Avenue A633, P.O. Box 0738, San Francisco, CA 94143-0738, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Urology, University of California, 400 Parnassus Avenue A633, P.O. Box 0738, San Francisco, CA 94143-0738</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature</title>
<author><name sortKey="Barski, D" sort="Barski, D" uniqKey="Barski D" first="D." last="Barski">D. Barski</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, Lukas Hospital, Preussenstrasse 84, 41464 Neuss, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Urology, Lukas Hospital, Preussenstrasse 84, 41464 Neuss</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Deng, D Y" sort="Deng, D Y" uniqKey="Deng D" first="D. Y." last="Deng">D. Y. Deng</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Urology, University of California, 400 Parnassus Avenue A633, P.O. Box 0738, San Francisco, CA 94143-0738, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Urology, University of California, 400 Parnassus Avenue A633, P.O. Box 0738, San Francisco, CA 94143-0738</wicri:regionArea>
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<series><title level="j">BioMed Research International</title>
<idno type="ISSN">2314-6133</idno>
<idno type="eISSN">2314-6141</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><p><italic>Purpose.</italic>
To evaluate the surgical treatment concepts for the complications related to the implantation of mesh material for urogynecological indications. <italic>Materials and Methods.</italic>
A review of the current literature on PubMed was performed. <italic>Results.</italic>
Only retrospective studies were detected. The rate of mesh-related complications is about 15–25% and mesh erosion is up to 10% for POP and SUI repair. Mesh explantation is necessary in about 1-2% of patients due to complications. The initial approach appears to be an early surgical treatment with partial or complete mesh resection. Vaginal and endoscopic access for mesh resection is favored. Prior to recurrent surgeries, a careful examination and planning for the operation strategy are crucial. <italic>Conclusions.</italic>
The data on the management of mesh complication is scarce. Revisions should be performed by an experienced surgeon and a proper follow-up with prospective documentation is essential for a good outcome.</p>
</div>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Biomed Res Int</journal-id>
<journal-id journal-id-type="iso-abbrev">Biomed Res Int</journal-id>
<journal-id journal-id-type="publisher-id">BMRI</journal-id>
<journal-title-group><journal-title>BioMed Research International</journal-title>
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<issn pub-type="ppub">2314-6133</issn>
<issn pub-type="epub">2314-6141</issn>
<publisher><publisher-name>Hindawi Publishing Corporation</publisher-name>
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<article-meta><article-id pub-id-type="pmid">25973425</article-id>
<article-id pub-id-type="pmc">4418012</article-id>
<article-id pub-id-type="doi">10.1155/2015/831285</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
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</article-categories>
<title-group><article-title>Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-8611-8250</contrib-id>
<name><surname>Barski</surname>
<given-names>D.</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
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<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Deng</surname>
<given-names>D. Y.</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Department of Urology, Lukas Hospital, Preussenstrasse 84, 41464 Neuss, Germany</aff>
<aff id="I2"><sup>2</sup>
Department of Urology, University of California, 400 Parnassus Avenue A633, P.O. Box 0738, San Francisco, CA 94143-0738, USA</aff>
<author-notes><corresp id="cor1">*D. Barski: <email>dbarski@lukasneuss.de</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Uwe Klinge</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>20</day>
<month>4</month>
<year>2015</year>
</pub-date>
<volume>2015</volume>
<elocation-id>831285</elocation-id>
<history><date date-type="received"><day>27</day>
<month>6</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>31</day>
<month>10</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2015 D. Barski and D. Y. Deng.</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p><italic>Purpose.</italic>
To evaluate the surgical treatment concepts for the complications related to the implantation of mesh material for urogynecological indications. <italic>Materials and Methods.</italic>
A review of the current literature on PubMed was performed. <italic>Results.</italic>
Only retrospective studies were detected. The rate of mesh-related complications is about 15–25% and mesh erosion is up to 10% for POP and SUI repair. Mesh explantation is necessary in about 1-2% of patients due to complications. The initial approach appears to be an early surgical treatment with partial or complete mesh resection. Vaginal and endoscopic access for mesh resection is favored. Prior to recurrent surgeries, a careful examination and planning for the operation strategy are crucial. <italic>Conclusions.</italic>
The data on the management of mesh complication is scarce. Revisions should be performed by an experienced surgeon and a proper follow-up with prospective documentation is essential for a good outcome.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>Treatment failure risk for mesh-related complication after conservative treatment versus mesh excision. CI: confidence interval; M-H: Mantel-Haenszel [<xref rid="B15" ref-type="bibr">15</xref>
–<xref rid="B17" ref-type="bibr">17</xref>
, <xref rid="B23" ref-type="bibr">20</xref>
].</p>
</caption>
<graphic xlink:href="BMRI2015-831285.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label>
<caption><p>Recurrent incontinence after MUS-mesh excision (mean), <italic>P</italic>
< 0.05.</p>
</caption>
<graphic xlink:href="BMRI2015-831285.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label>
<caption><p>Subjective cure rate after MUS-mesh excision (mean), <italic>P</italic>
< 0.05.</p>
</caption>
<graphic xlink:href="BMRI2015-831285.003"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Studies on management of mesh related complications after incontinence and prolapse surgeries.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Author </th>
<th align="center" rowspan="1" colspan="1">Trial</th>
<th align="left" rowspan="1" colspan="1">Number of patients</th>
<th align="center" rowspan="1" colspan="1">Mesh</th>
<th align="left" rowspan="1" colspan="1">Complications</th>
<th align="center" rowspan="1" colspan="1">Median time to revision</th>
<th align="left" rowspan="1" colspan="1">Management</th>
<th align="center" rowspan="1" colspan="1">Concomitant procedure</th>
<th align="left" rowspan="1" colspan="1">Follow-up</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Abbot et al.<break></break>
2014 [<xref rid="B17" ref-type="bibr">17</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">347 (49.9% MUS; 25.6% TVM or CSP; 24.2% combination)</td>
<td align="center" rowspan="1" colspan="1">Various</td>
<td align="left" rowspan="1" colspan="1">30% dyspareunia <break></break>
42.7% mesh erosion <break></break>
34.6% pelvic pain <break></break>
77% grade 3 or 4 (reoperation) complication</td>
<td align="center" rowspan="1" colspan="1">5.8 mos (0–65.2 mos)</td>
<td align="left" rowspan="1" colspan="1">(1) Trimming of mesh/partial excision (50.9%) <break></break>
(2) Release of mesh arms (18.1%) <break></break>
(3) Complete intravaginal mesh excision (26.9%) <break></break>
(4) Recurrent prolapse treatment (23.2%) <break></break>
(5) Recurrent incontinence treatment (14.8%) <break></break>
(6) Other surgeries (20.1%) <break></break>
(7) Initial conservative treatment (23%) <break></break>
60% ≥2 interventions </td>
<td align="center" rowspan="1" colspan="1">MUS</td>
<td align="left" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Agnew et al.<break></break>
2012 [<xref rid="B24" ref-type="bibr">18</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">63 MUS</td>
<td align="center" rowspan="1" colspan="1">Various synthetics (67% monofilament TVT, 17% TOT)</td>
<td align="left" rowspan="1" colspan="1">100% voiding dysfunction</td>
<td align="center" rowspan="1" colspan="1">12.4 mos (1 week–8 yrs)</td>
<td align="left" rowspan="1" colspan="1">(1) Simple sling division (73%) <break></break>
(2) Partial excision of sling (21%) <break></break>
(3) Concomitant procedure to prevent Re-SUI (4/63)</td>
<td align="center" rowspan="1" colspan="1">Burch, MUS</td>
<td align="left" rowspan="1" colspan="1">Persistent voiding dysfunction <break></break>
(1) 10.9%; (2) 7.7%; (3) 50% (<italic>P</italic>
= 0.09) <break></break>
Subsequent surgery for recurrent SUI <break></break>
(1) 2.2%; (2) 23.1%; (3) 0% (<italic>P</italic>
= 0.04) <break></break>
De novo urgency <break></break>
(1) 10.9%; (2) 15.4%; (3) 25% (<italic>P</italic>
= 0.51)</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Blaivas et al.<break></break>
2013 [<xref rid="B25" ref-type="bibr">19</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">47 MUS</td>
<td align="center" rowspan="1" colspan="1">Type 1 76% <break></break>
Types 2–3 23%</td>
<td align="left" rowspan="1" colspan="1">OAB (70%) <break></break>
SUI (55%) <break></break>
Recurrent UTI (21%) <break></break>
Pelvic pain/dysuria (34%) <break></break>
Obstructive symptoms (9%) <break></break>
Vaginal extrusion (9%)</td>
<td align="center" rowspan="1" colspan="1">2 yrs (1 mos–8 yrs)</td>
<td align="left" rowspan="1" colspan="1">(1) Sling excision + urethrolysis (34%) <break></break>
(2) Sling excision + urethral reconstruction (including fistula repair) + autologous fascial sling (30%) <break></break>
(3) Sling incision (21%) <break></break>
(4) Partial cystectomy (10%) <break></break>
(5) Ureteroneocystostomy (4%)</td>
<td align="center" rowspan="1" colspan="1">MUS</td>
<td align="left" rowspan="1" colspan="1">2 yrs (0.25–12 yrs) <break></break>
Successful treatment 72% <break></break>
28% recurrent surgery <break></break>
refractory pain (19%), mesh extrusion (17%), and OAB (8%)</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Costantini et al.<break></break>
2011 [<xref rid="B23" ref-type="bibr">20</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">12 (12/179, 6.7%) mesh erosion after abdominal CSP</td>
<td align="center" rowspan="1" colspan="1">11 PP, 1 Gore-Tex</td>
<td align="left" rowspan="1" colspan="1">100% mesh erosion <break></break>
41% vaginal bleeding <break></break>
33% asymptomatic <break></break>
17% dyspareunia <break></break>
17% infection (1x Gore-Tex) </td>
<td align="center" rowspan="1" colspan="1">22.9 mos (2–66 mos)</td>
<td align="left" rowspan="1" colspan="1">(1) Antibiotics and local estrogen (100%) <break></break>
(2) Vaginal (partial) mesh resection (83%) <break></break>
(3) Abdominal resection (17%) <break></break>
(4) Endoscopic (8%) </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">57 mos (18–120 mos) <break></break>
(1) All needed surgery <break></break>
(3) Recurrent cystocele <break></break>
(4) Fistula, abdominal revision </td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Davis et al.<break></break>
2012 [<xref rid="B26" ref-type="bibr">21</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">12 TVT</td>
<td align="center" rowspan="1" colspan="1">PP</td>
<td align="left" rowspan="1" colspan="1">100% mesh erosion </td>
<td align="center" rowspan="1" colspan="1">59 mos (7–144 mos)</td>
<td align="left" rowspan="1" colspan="1">Endoscopic holmium: YAG laser excision (100%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">65.5 mos (6–134 mos) <break></break>
33% second laser excision <break></break>
17% surgery for recurrent SUI <break></break>
8% (1 patient) abdominal mesh resection</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Firoozi et al.<break></break>
2012 [<xref rid="B28" ref-type="bibr">22</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">23 TVM for POP</td>
<td align="center" rowspan="1" colspan="1">Various PP</td>
<td align="left" rowspan="1" colspan="1">Vaginal/pelvic pain (39%), dyspareunia (39%), vaginal mesh extrusion/exposure (26%), urinary incontinence (35%), recurrent pelvic organ prolapse (22%), bladder mesh perforation (22%), rectal mesh perforation (4%), ureteral perforation injury (4%), and vesicovaginal fistula (9%)</td>
<td align="center" rowspan="1" colspan="1">10 mos (1–27 mos)</td>
<td align="left" rowspan="1" colspan="1">(1) Transvaginal excision (90%) <break></break>
(2) Transvaginal/endoscopic (5%) <break></break>
(3) Transrectal/transperineal (5%) <break></break>
(4) Concomitant POP/SUI repair (45%)</td>
<td align="center" rowspan="1" colspan="1">TVM, MUS</td>
<td align="left" rowspan="1" colspan="1">3 mos <break></break>
14% UTI <break></break>
4.3% collagen injection for Re-SUI <break></break>
4.3% PFT for perineal pain </td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Greiman and Kielb 2012 [<xref rid="B35" ref-type="bibr">23</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">28 (28/118, 23%) MUS</td>
<td align="center" rowspan="1" colspan="1">PP</td>
<td align="left" rowspan="1" colspan="1">Intravesical sling (4%), extruded vaginal mesh (93%), obstructive voiding symptoms (78%), dyspareunia (42%), and vaginal bleeding (21%)</td>
<td align="center" rowspan="1" colspan="1">15 mos</td>
<td align="left" rowspan="1" colspan="1">(1) Sling loosening, incision in the midline <break></break>
(2) If mesh erosion >1 cm a resection </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">11% reoperation for mesh extrusion, no other complications</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Hammett et al.<break></break>
2014 [<xref rid="B27" ref-type="bibr">24</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">57 patients (26 MUS, 23 TVM, and 9 intraperitoneal prolapse CSP)</td>
<td align="center" rowspan="1" colspan="1">Various PP</td>
<td align="left" rowspan="1" colspan="1">100% mesh erosion with pelvic pain (55.9%), dyspareunia (54.4%), and vaginal discharge (30.9%).</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">(1) Vaginal mesh excision (91%) <break></break>
(2) Abdominal resection (all CSP, <italic>n</italic>
= 9/15, 40%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">6 weeks <break></break>
57% symptoms completely resolved <break></break>
12% required more than 1 surgery for mesh excision <break></break>
(1) 9% UTI <break></break>
(2) 4.5% cardiopulmonal complications; 18% sepsis; 45% wound infection </td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Hampel et al.<break></break>
2009 [<xref rid="B18" ref-type="bibr">25</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">48 MUS (44 TVT, 4 TOT)</td>
<td align="center" rowspan="1" colspan="1">Various PP</td>
<td align="left" rowspan="1" colspan="1">De novo urge (65%), mesh erosion (21%), dyspareunia (19%), UTI (35%), and fistula (6%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">(1) Partial mesh resection (trans-/suburethral, 23%) <break></break>
(2) Self-catheterisation (23%) <break></break>
(3) Botox/neuromodulation (27%) <break></break>
(4) Fascia plastic (10%) <break></break>
(5) Complete abdominal-vaginal mesh resection (8%) <break></break>
(6) Urinary diversion (2%) <break></break>
(7) Fistula repair (6%) <break></break>
(8) Conservative treatment (25%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">42% symptoms completely resolved</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Kasyan et al.<break></break>
2014 [<xref rid="B15" ref-type="bibr">15</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">152 TVM</td>
<td align="center" rowspan="1" colspan="1">Prolift (Gynecare), PP </td>
<td align="left" rowspan="1" colspan="1">Erosions (21%), dyspareunia (11%), mesh shrinkage (4.4%), pelvic abscess (2.7%), and fistula (1.3%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">(1) Conservative treatment with local oestrogen <break></break>
(2) Partial/total mesh excision</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Nguyen et al.<break></break>
2012 [<xref rid="B19" ref-type="bibr">26</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">82 MUS (2.2%)</td>
<td align="center" rowspan="1" colspan="1">Various </td>
<td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">(1) Sling loosening or transaction for voiding dysfunction (60%) <break></break>
(2) Excision for vaginal mesh exposure 30 (36%) <break></break>
(3) Excision for pain (1.2%) <break></break>
(4) Excision for urethral erosion (1.2%) <break></break>
(5) Drainage of retropubic hematoma (1.2%)</td>
<td align="center" rowspan="1" colspan="1">MUS, colporrhaphy, and CSP</td>
<td align="left" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Abdel-Fattah et al. 2006 [<xref rid="B16" ref-type="bibr">16</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">34 TVM (2.2%)</td>
<td align="center" rowspan="1" colspan="1">Various</td>
<td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">(1) Excision for vaginal mesh exposure (85%) <break></break>
(2) Excision of vaginal suture (6%) <break></break>
(3) Biologic graft reoperation (12%) <break></break>
(4) Drainage hematoma/abscess (6%) <break></break>
(5) Bowel resection for obstruction (3%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Padmanabhan <break></break>
et al. 2012 [<xref rid="B36" ref-type="bibr">27</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">85 (MUS, TVM)</td>
<td align="center" rowspan="1" colspan="1">Various PP</td>
<td align="left" rowspan="1" colspan="1">Perforation of urethra (14%), bladder (36%), and vagina (50%) </td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">(1) Vaginal excision (14%) <break></break>
(2) Lower urinary tract excision (47%) <break></break>
(3) Partial cystectomy (21%) <break></break>
(4) Urethroplasty (21%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">Subjective cure in 75% and improvement in 21% SUI (6.6–12.5%)</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Renezeder <break></break>
et al. 2011 [<xref rid="B37" ref-type="bibr">28</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">118 (80% MUS, 20% TVM)</td>
<td align="center" rowspan="1" colspan="1">Various PP (88% type 1)</td>
<td align="left" rowspan="1" colspan="1">De novo urgency (46.6%), dyspareunia (41.5%), recurrent UTI (39.0%), mesh erosion (37%), and vaginal bleeding (9.3%)</td>
<td align="center" rowspan="1" colspan="1">27 mos (1–89 mos)</td>
<td align="left" rowspan="1" colspan="1">(1) Tissue patch covering (17.8%) <break></break>
(2) Partial removal (65.3%) <break></break>
(3) Complete removal per laparotomy (12.7%) <break></break>
(4) Bone stabilization (0.8%) <break></break>
(5) Excision of granulation tissue (3.4%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">8 weeks <break></break>
45.5% urgency</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Ridgeway et al. 2008 [<xref rid="B38" ref-type="bibr">29</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">19 TVM</td>
<td align="center" rowspan="1" colspan="1">Monofilament PP</td>
<td align="left" rowspan="1" colspan="1">Chronic pain (31%), dyspareunia (31%), recurrent pelvic organ prolapse (42%), mesh erosion (63%), and vesicovaginal fistula (16%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">Partial tailored vaginal mesh resection with concomitant procedures </td>
<td align="center" rowspan="1" colspan="1">Burch, MUS</td>
<td align="left" rowspan="1" colspan="1">33 weeks (16–75 weeks) <break></break>
16% UTI <break></break>
5% hematoma <break></break>
21% persistent symptoms</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Rouprêt et al. 2010 [<xref rid="B21" ref-type="bibr">30</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">38 TVT</td>
<td align="center" rowspan="1" colspan="1">PP</td>
<td align="left" rowspan="1" colspan="1">Mesh erosion/extrusion (42%), pelvic pain (39%), and obstruction (18%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">(1) Laparoscopic (97%) <break></break>
(2) Laparoscopic + vaginal (3%)</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="left" rowspan="1" colspan="1">38 mos (2–80) <break></break>
Healing and pain release (100%) <break></break>
Recurrent SUI (66%)</td>
</tr>
<tr><td align="center" colspan="9" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Shah et al.<break></break>
2013 [<xref rid="B39" ref-type="bibr">31</xref>
]</td>
<td align="center" rowspan="1" colspan="1">RT</td>
<td align="left" rowspan="1" colspan="1">21 MUS</td>
<td align="center" rowspan="1" colspan="1">Polypropylene, type I</td>
<td align="left" rowspan="1" colspan="1">Urethral perforation (67%), bladder perforation (33%), fistula (19%), vaginal pain (67%), urgency (29%), incontinence (38%), obstruction (33%), dyspareunia (19%), and hematuria (24%)</td>
<td align="center" rowspan="1" colspan="1">15.5 mos (1–60 mos)</td>
<td align="left" rowspan="1" colspan="1">(near) Total mesh excision, urinary tract reconstruction, and concomitant pubovaginal sling with autologous rectus fascia</td>
<td align="center" rowspan="1" colspan="1">MUS, urethroplasty</td>
<td align="left" rowspan="1" colspan="1">22 mos (6–98 mos) <break></break>
Continence (81%) <break></break>
Incisional seroma (9.5%) <break></break>
Additional procedures (36%) <break></break>
UTI (9.5%) <break></break>
Pelvic pain (9.5%) <break></break>
dyspareunia 9.5%</td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>RT: retrospective trial; PT: prospective trial; MUS: midurethral sling; TVM: transvaginal mesh; TVT: tension-free vaginal tape; TOT: transobturator tape; CSP: colposacropexy; PP: polypropylene.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Complications of midurethral slings (total number: 388 women sent for revision) [<xref rid="B14" ref-type="bibr">14</xref>
].</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Complications</th>
<th align="center" rowspan="1" colspan="1">Number</th>
<th align="center" rowspan="1" colspan="1">Percentage</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Overactive bladder </td>
<td align="center" rowspan="1" colspan="1">201</td>
<td align="center" rowspan="1" colspan="1">51.8%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Lower urinary tract obstruction </td>
<td align="center" rowspan="1" colspan="1">173</td>
<td align="center" rowspan="1" colspan="1">44.58%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Recurrence of SUI </td>
<td align="center" rowspan="1" colspan="1">101</td>
<td align="center" rowspan="1" colspan="1">26.03%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Vaginal exposure </td>
<td align="center" rowspan="1" colspan="1">68</td>
<td align="center" rowspan="1" colspan="1">17.52%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Pain </td>
<td align="center" rowspan="1" colspan="1">54</td>
<td align="center" rowspan="1" colspan="1">13.91%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Infective complications </td>
<td align="center" rowspan="1" colspan="1">48</td>
<td align="center" rowspan="1" colspan="1">12.37%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Dyspareunia </td>
<td align="center" rowspan="1" colspan="1">22</td>
<td align="center" rowspan="1" colspan="1">5.67%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Vesicovaginal fistula</td>
<td align="center" rowspan="1" colspan="1">14</td>
<td align="center" rowspan="1" colspan="1">3.6%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Inrolled sling or contraction of material</td>
<td align="center" rowspan="1" colspan="1">18</td>
<td align="center" rowspan="1" colspan="1">4.63%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Intraoperative bladder injury </td>
<td align="center" rowspan="1" colspan="1">11</td>
<td align="center" rowspan="1" colspan="1">2.83%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Groin/upper thigh pain</td>
<td align="center" rowspan="1" colspan="1">11</td>
<td align="center" rowspan="1" colspan="1">2.83%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Postoperative hematoma </td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">2.57%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Bladder/urethral penetration</td>
<td align="center" rowspan="1" colspan="1">18</td>
<td align="center" rowspan="1" colspan="1">4.63%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Foreign body sensation in vagina </td>
<td align="center" rowspan="1" colspan="1">6</td>
<td align="center" rowspan="1" colspan="1">1.54%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Husband's penis laceration </td>
<td align="center" rowspan="1" colspan="1">6</td>
<td align="center" rowspan="1" colspan="1">1.54%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Groin infection</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">1.03%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Necrotizing fasciitis</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">0.77%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Retropubic abscess</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">0.77%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Urethrovaginal fistula </td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">0.51%</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Intraoperative bowel injury</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">0.25%</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
</record>
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