A case of mesh erosion in the ureter eight years after a tension-free vaginal mesh surgery

2019 ◽  
Vol 30 (12) ◽  
pp. 2199-2200
Author(s):  
Tomomi Nakagawa ◽  
Shohei Kawaguchi ◽  
Atsushi Mizokami
Keyword(s):  
Mesh Erosion ◽  
Vaginal Mesh ◽  
Tension Free ◽  
Mesh Surgery

scholarly journals Amniotic Membrane Graft in the Management of Complex Vaginal Mesh Erosion

2020 ◽  
Vol 9 (2) ◽  
pp. 356
Author(s):  
Hui-Hsuan Lau ◽  
Quan-Bin Jou ◽  
Wen-Chu Huang ◽  
Tsung-Hsien Su
Keyword(s):  
Amniotic Membrane ◽  
Intraoperative Complications ◽  
Mesh Erosion ◽  
Surgical Revision ◽  
Vaginal Mesh ◽  
Management Options ◽  
Mesh Surgery ◽  
Amniotic Graft ◽  
Vaginal Erosions

Vaginal mesh erosion is a devastating complication after pelvic floor mesh surgery and it can be treated conservatively or with surgical revision. However, the management options following a failed primary revision or complex vaginal erosions are very limited. The aim of this study is to describe a novel treatment using an amniotic membrane as an inlay graft for such patients. Eight patients who failed conservative or primary surgical revision were enrolled. The complex erosions included vaginal agglutination, multiple vaginal erosions, recurrent erosions, and mesh cutting through the urethra. We used an amniotic membrane as a graft to cover the vaginal defect after partial excision of the mesh erosion and we describe the technique in this study. There were no intraoperative complications and none of the patients reported any further symptoms at a mean of 27 months follow-up. Only one patient had recurrent erosion, however, the erosion size was narrower and was subsequently successfully repaired. No further vaginal mesh erosions were noted in the other patients who all had good functional recovery. The use of an amniotic graft can be an economic and alternative method in the management of complex vaginal mesh erosions.

scholarly journals Comparative Retrospective Study of Tension-Free Vaginal Mesh Surgery, Native Tissue Repair, and Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse Repair

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Haruhiko Kanasaki ◽  
Aki Oride ◽  
Tomomi Hara ◽  
Satoru Kyo
Keyword(s):  
Pelvic Organ Prolapse ◽  
Recurrence Rate ◽  
Tissue Repair ◽  
Pelvic Organ ◽  
Mesh Erosion ◽  
Vaginal Mesh ◽  
Laparoscopic Sacrocolpopexy ◽  
Native Tissue Repair ◽  
Tension Free ◽  
Significant Difference

Introduction and Hypothesis. Many would argue that sacrocolpopexy is the standard surgical procedure for pelvic organ prolapse (POP), but other surgical techniques were proposed and practically applying to the patients with POP. In this study, we compared postoperative outcomes of three surgical methods for POP repair. Methods. We identified that 308 women who had undergone surgical repair of POP were followed up for at least 6 months. Recurrence rates of POP after tension-free vaginal mesh (TVM) surgery (n = 243), native tissue repair (NTR) (vaginal hysterectomy with colpopexy, anterior and posterior colpoplasty, or circumferential suturing of the levator ani muscles and apical repair by transvaginal sacrospinous ligament fixation (SSLF)) (NTR; n = 31), and laparoscopic sacrocolpopexy after subtotal hysterectomy (LSC; n = 34) were compared. Presence of mesh erosion was also recorded. Results. Patients who underwent LSC were significantly younger (65.32 ± 3.23 years) than those who underwent TVM surgery (69.61 ± 8.31 years). After TVM surgery, the rate of recurrence (over POP-Q stage II) was 6.17% (15/243) and was highest in patients with advanced POP. The recurrence rate in patients who underwent NTR procedure was 3.23% (1/34) and that in patients who underwent LSC was 11.76% (4/11). There was no statistically significant difference in the recurrence rate between the three types of surgery. There were 13 cases (5.35%) of mesh erosion after TVM surgery and none after LSC surgery. The risk of mesh erosion was correlated with having had total TVM surgery but not with patient age or POP stage. Repeat procedures were performed in 5 women (2.14%) who underwent TVM surgery and 1 (2.94%) who underwent LSC. No patient underwent repeat surgery after NTR. There was no statistically significant difference in the reoperation rate between the three types of surgery. Conclusion. Our study suggested that TVM surgery, NTR, and LSC have comparable outcomes as for the postoperative recurrence rate and mesh erosion. However, the outcomes of each technique need to be carefully evaluated over a long period of time.

scholarly journals Pregnancy after tension-free vaginal mesh (anterior Prolift) and concomitant tension-free vaginal tape-obturator procedure

2011 ◽  
Vol 25 (1) ◽  
pp. 17
Author(s):  
Xiao Luo ◽  
Li Xiao Wan ◽  
Hong Shen ◽  
Yin Xiu Xia ◽  
Chao Han Zhang ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Young Patients ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Vaginal Mesh ◽  
Pelvic Floor Reconstruction ◽  
Tension Free ◽  
Tension Free Vaginal Tape ◽  
History Of ◽  
Vaginal Tape Obturator

<em>Objective</em>. Treatment of anterior vaginal wall prolapse and stress urinary incontinence (SUI) with transobturator tension-free vaginal mesh (anterior Prolift) and concomitant tension-free vaginal tape-obturator (TVT-O) has been proved feasible, safe and effective. However, there is little known about the influence of pregnancy on women who have had such procedures before pregnancy. <em>Design and methods.</em> A 32-year-old woman (gravid 1, para 1) with two years history of SUI and nine months history of pelvic organ prolapse (POP) was treated with transobturator tension-free vaginal mesh (anterior Prolift) and concomitant TVT-O. Her recovery was excellent, and she was pregnant eight months after the operation. <em>Results</em>. The patient went through her pregnancy smoothly with no special discomfort and successfully delivered an infant via caesarean section without recurrence of POP and SUI. Her last visit to our clinic about 14 months after caesarean section revealed that the anterior Prolift mesh and TVT-O mesh still remained intact and the position of the vaginal fornix, anterior and posterior walls and uterus also remained normal. <em>Conclusions</em>: Pelvic floor reconstruction with vaginal mesh (Prolift) may have positive significance for young patients who desire uterine preservation for future pregnancies. However, further studies are warranted to determine whether it can be used in pregnant women or women planning future pregnancies.

Long-term observation on postoperative recurrence and complications of transvaginal mesh surgery for pelvic organ prolapse

2021 ◽  
Author(s):  
Junfang Yang ◽  
Kun Zhang ◽  
Jinsong Han ◽  
Yiting Wang ◽  
Ying Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Protective Factor ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Transvaginal Mesh ◽  
Mesh Exposure ◽  
Mesh Surgery ◽  
Post Menopause

Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design：This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data. Conclusion: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however，concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

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