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Multicenter Study
. 2011 Sep;118(3):629-636.
doi: 10.1097/AOG.0b013e31822ada95.

Risk factors for exposure, pain, and dyspareunia after tension-free vaginal mesh procedure

Mariëlla I Withagen  1 , Mark E Vierhout, Jan C Hendriks, Kirsten B Kluivers, Alfredo L Milani
Affiliations
Multicenter Study

Risk factors for exposure, pain, and dyspareunia after tension-free vaginal mesh procedure

Mariëlla I Withagen et al. Obstet Gynecol. 2011 Sep.

Abstract

Objective: To identify possible risk factors for exposure, dyspareunia, and pain after insertion of tension-free vaginal mesh in pelvic organ prolapse surgery.

Methods: This was a prospective observational cohort study. Consecutive women who underwent surgery with a trocar-guided tension-free vaginal mesh kit were included and evaluated at 6 weeks and at 6 and 12 months after surgery with respect to anatomy and complications. Logistic regression analysis was performed to identify risk factors for exposure, dyspareunia, and pain.

Results: Two hundred ninety-four patients were included. Exposure was found in 34 patients (12%). Smoking and total mesh were risk factors for exposure (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.1-8.7 and OR 3.0, 95% CI 1.2-7.0, respectively). Clinical and surgical experience were inversely related to the risk of exposure (OR 0.5, 95% CI 0.3-0.8 per decade). Pain (OR 3.2, 95% CI 1.2-8.4) and dyspareunia (OR 4.7, 95% CI 1.7-12.8) before surgery were predictive for pain and dyspareunia after surgery, respectively. Pain after surgery was found in 35 out of 275 (13%) patients and dyspareunia was found in 77 out of 171 (45%) patients.

Level of evidence: Smoking, total tension-free vaginal mesh, and experience were predictive factors for mesh exposure.

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References

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