Beyond the complications: medium-term anatomical, sexual and functional outcomes following removal of trocar-guided transvaginal mesh. A retrospective cohort study

Jeffery ST et al. – There were no symptoms relating to prolapse in any of the women at 6 weeks, 6, 12 or 24 months. Authors report satisfactory outcomes following removal of a complicated TVM kit.

Methods

• This was a retrospective analysis of a clinical database of women who had developed a complication following a TVM procedure.
• This included dyspareunia, mesh erosion, urinary symptoms, mesh contraction and prolapse recurrence.
• Pre– and post–operatively, we assessed the women for prolapse, stress incontinence, urgency, defecatory difficulty, digitation, pain, dyspareunia and apareunia.
• They also recorded the Pelvic Organ Prolapse Quantification (POP–Q) score.
• The TVM was removed and a Biodesign graft was used in the majority of cases to prevent further prolapse.
• Follow–up was at 6 weeks, 6 months, 1 and 2 years.

Results

• In the cohort of 21 women, 18 required surgery for pain and/or dyspareunia; 20 women had reached the 6–week follow–up at the time of analysis.
• At 6 weeks, two women still had pain and required a second intervention.
• Fifteen women had reached a 6–month follow–up and only one woman had persistent pain requiring repeat surgery.
• Of the 15 women, 7 were sexually active and in 6 cases the dyspareunia had resolved completely with 1 woman retaining an element of pain at intercourse.
• Six women had been seen at 12 months and all four of the sexually active women had no dyspareunia.
• There were no symptoms relating to prolapse in any of the women at 6 weeks, 6, 12 or 24 months.

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