Beyond the complications: medium-term anatomical, sexual and functional outcomes following removal of trocar-guided transvaginal mesh. A retrospective cohort study
International Urogynecology Journal, 04/30/2012
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.
- 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.