Long-term follow-up of persistent vaginal polypropylene mesh exposure for transvaginally placed mesh procedures

Abstract

Introduction and hypothesis: The surgical treatment of a cystocele via the vaginal route may require the placement of a synthetic mesh below the bladder. However, the placement of a synthetic mesh via the vaginal route can be associated with specific complications, such as vaginal mesh exposure. There is a lack of data concerning the long-term follow-up of asymptomatic persistent vaginal polypropylene mesh exposure.

Methods: This was a retrospective case series of nine patients presenting with persistent vaginal mesh exposure following the placement of a macroporous monofilament polypropylene mesh for cystocele treatment. Expectant management has been proposed since the patients were asymptomatic.

Results: The median follow-up duration was 121 months [interquartile range (IQR) 119-132]. The median surface area of vaginal mesh exposure (1 cm(2); IQR 1-1) did not change significantly during the follow-up. No pelvic or perineal abscess occurred during the follow-up. Only one of them was sexually active; she complained of dyspareunia at the last follow-up, but refused renewed surgery since she had sexual intercourse on only a small number of occasions per year. Clinical examination using the International Continence Society Pelvic Organ Prolapse Quantification system: Ba -3 to -2 (n = 7; 88 %), Ba -1 (n = 1; 12 %), Ba 0 or greater (n = 0).

Conclusions: Persistent asymptomatic vaginal polypropylene mesh exposure is associated with few complications at long-term follow-up.