Factors associated with exposure of transvaginally placed polypropylene mesh for pelvic organ prolapse

• Published in: International Urogynecology Journal Vol. 23; no. 10; pp. 1461 - 1466
• Main Authors: Gold, Karen P., Ward, Renee M., Zimmerman, Carl W., Biller, Daniel H., McGuinn, Shawn, Slaughter, James C., Dmochowski, Roger R.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-10-2012; Springer Nature B.V
• Subjects: Adult; Age Factors; Aged; Case-Control Studies; Equipment Failure; Female; Gynecologic Surgical Procedures - methods; Gynecology; Hemorrhage - complications; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pelvic Organ Prolapse - surgery; Polypropylenes; Reoperation; Retrospective Studies; Risk Factors; Smoking - adverse effects; Surgical Mesh - adverse effects; Urology; Vagina - surgery; Mesh exposure; Polypropylene mesh; Pelvic organ prolapse; Transvaginal mesh
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-012-1706-2

Introduction and hypothesis
This study evaluates potential risk factors for mesh exposure following transvaginal placement of polypropylene mesh for pelvic organ prolapse requiring reoperation.
Methods
We performed a case-control study. Cases had mesh exposure requiring surgical revision; controls had no mesh exposures and were chosen for similar surgical date and type of mesh.
Results
We identified 48 cases and 48 controls. The adjusted odds ratio of having a bleeding complication at the time of mesh implantation was 7.25 [95% confidence interval (CI) 1.47–35.66], smokers versus nonsmokers was 3.17 (95% CI 0.59–17.12), and being 1 year older was 0.96 (95% CI 0.92–1.0), among women with mesh exposure.
Conclusions
We identified bleeding complications at the time of mesh implantation as a risk factor for mesh exposure requiring reoperation. Despite being one of the largest studies on this topic, our data were inconclusive regarding the impact of other possible factors on mesh exposure.