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. 2021 Mar;32(3):573-580.
doi: 10.1007/s00192-020-04612-x. Epub 2020 Nov 25.

Comparison of synthetic mesh erosion and chronic pain rates after surgery for pelvic organ prolapse and stress urinary incontinence: a systematic review

Eoin MacCraith  1   2 , Eoghan M Cunnane  3 , Michael Joyce  3 , James C Forde  3   4 , Fergal J O'Brien  3 , Niall F Davis  3   4
Affiliations

Comparison of synthetic mesh erosion and chronic pain rates after surgery for pelvic organ prolapse and stress urinary incontinence: a systematic review

Eoin MacCraith et al. Int Urogynecol J. 2021 Mar.

Abstract

Background: The aim of this study is to systematically compare rates of erosion and chronic pain after mesh insertion for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) surgery.

Methods: A systematic electronic search was performed on studies that evaluated the incidence of erosion and chronic pain after mesh insertion for POP or SUI. The primary outcome measurement was to compare mesh erosion rates for POP and SUI surgery. Secondary outcome measurements were incidence of de novo pain and a comparison of patient demographics for both surgeries.

Results: Twenty-six studies on 292,606 patients (n = 9077 for POP surgery and n = 283,529 for SUI surgery) met the inclusion criteria. Median follow-up was 26.38 ± 22.17 months for POP surgery and 39.33 ± 27.68 months for SUI surgery. Overall, the POP group were older (p < 0.0001) and had a lower BMI (p < 0.0001). Mesh erosion rates were significantly greater in the POP group compared to the SUI group (4% versus 1.9%) (OR 2.13; 95% CI 1.91-2.37; p < 0.0001). The duration from surgery to onset of mesh erosion was 306.84 ± 183.98 days. There was no difference in erosion rates between abdominal and transvaginal mesh for POP. There was no difference in erosion rates between the transobturator and retropubic approach for SUI. The incidence of chronic pain was significantly greater in the POP group compared to the SUI group (6.7% versus 0.6%) (OR 11.02; 95% CI 8.15-14.9; p < 0.0001). The duration from surgery to onset of chronic pain was 325.88 ± 226.31 days.

Conclusions: The risk of mesh erosion and chronic pain is significantly higher after surgery for POP compared to SUI. These significant complications occur within the first year after surgery.

Keywords: Chronic pain; Erosion; Exposure; Mesh; Pelvic organ prolapse; Polypropylene; Sling; Stress urinary incontinence; Tape.

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References

    1. Haylen BT, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(1):5–26. - PubMed
    1. Mettu JR, Colaco M, Badlani GH. Evidence-based outcomes for mesh-based surgery for pelvic organ prolapse. Curr Opin Urol. 2014;24(4):370–4. - PubMed
    1. Norton P, Brubaker L. Urinary incontinence in women. Lancet. 2006;367(9504):57–67. - PubMed
    1. Wu JM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6. - PubMed - PMC
    1. Gibson W, Wagg A. Are older women more likely to receive surgical treatment for stress urinary incontinence since the introduction of the mid-urethral sling? An examination of hospital episode statistics data. Bjog. 2016;123(8):1386–92. - PubMed

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