Comparison of vaginal mesh extrusion rates between a lightweight type I polypropylene mesh versus heavier mesh in the treatment of pelvic organ prolapse
International Urogynecology Journal, 05/17/2012
Moore RD et al. – No statistically significant difference in extrusion rates were seen following use of IntePro versus IntePro Lite; however, the 46 % reduction in rate of mesh exposure observed in those receiving the lighter weight mesh may represent clinical importance.Methods
- Data were pooled from three similarly designed prospective multicenter studies evaluating the safety and efficacy of Perigee for correction of the anterior (AC) and/or Apogee to repair the posterior/apical (PC/A) compartments.
- The first two studies utilized IntePro (mesh density 50 g/m2) and the third utilized IntePro Lite (mesh density 25.2 g/m2). Data were pooled to form IntePro and IntePro Lite groups for comparison.
- Patient demographics were recorded. Risk factors for vaginal mesh exposure were also considered.
- Two hundred and sixty–three patients were implanted with Perigee and/or Apogee with IntePro for a total of 371 heavier mesh implants (174 Perigee, 197 Apogee) compared to 86 patients who underwent Perigee and/or Apogee with IntePro Lite for a total of 116 lightweight mesh implants (60 Perigee, 56 Apogee).
- Demographics and potential risk factors for extrusion were compared between the two groups.
- Mean follow–up was 2.0 years and similar between the two groups.
- In the AC, there were 234 implants, with mesh extrusion occurring in 8.0 % following IntePro compared to 5.0 % following IntePro Lite (p=0.57).
- In the PA/C, there were 253 implants, with mesh extrusion occurring in 13.7 % following IntePro compared to 7.1 % following IntePro Lite (p=0.25).
- Overall mesh extrusion rates in 487 implants in all compartments were found to be 11.1 % with IntePro versus 6.0 % with IntePro Lite with an estimated odds ratio of 1.93 (95 % confidence interval 0.84–4.44, p=0.12).