Managing mesh erosion after abdominal pelvic organ prolapse repair: Ten years' experience in a single center

Elisabetta Costantini, Alessandro Zucchi, Massimo Lazzeri, Michele Del Zingaro, Alberto Vianello, Massimo Porena

Research output: Contribution to journalArticle

Abstract

Objective: To report conservative and surgical strategies for treatment of mesh erosion after pelvic organ prolapse (POP) repair. Methods: Between 1998 and 2008, 179 patients underwent integral pelvic floor reconstruction for advanced POP in our tertiary urogynecological unit. Patients' charts and follow-up data were entered into a computerized database and data analysis performed to search for mesh erosion/complications/surgery. Results: 12 patients were diagnosed and treated for mesh erosion: in 10 of 179, surgery was performed in our department and the mesh used was polypropylene (PP): 3 after colposacropexy (CSP) (5.5%), 5 after CSP + hysterectomy (Hys) (6.5%), and 2 after hysterosacropexy (HSP) (3.9%); in 1 case, Gore-tex mesh was used, and another case had undergone CSP in another hospital using PP mesh. Time to mesh erosion ranged from 2 to 66 months (mean 22.9), with 4 erosions (33%) within 6 months of POP repair. In 4 asymptomatic patients (33%) erosion was incidentally discovered during clinical check-ups at 4, 31, 36 and 66 months. Five cases (41%) presented with occasional vaginal bleeding, associated with dyspareunia in 2. Treatments were individualized but in all cases conservative treatment was unable to resolve the complications and surgery was needed. At a mean follow-up of 57 months (range 18-120) after surgical treatment all patients were asymptomatic and free from erosions. Conclusions: The surgeon who approaches management of complications after abdominal/laparoscopic sacropexy should possess a comprehensive understanding of pelvic floor anatomy and surgical skills in order to individualize the management of such complications.

Original languageEnglish
Pages (from-to)419-423
Number of pages5
JournalUrologia Internationalis
Volume86
Issue number4
DOIs
Publication statusPublished - Jun 2011

Keywords

  • Infection
  • Mesh erosion
  • Pelvic organ prolapse
  • Surgery
  • Treatment

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Managing mesh erosion after abdominal pelvic organ prolapse repair: Ten years' experience in a single center'. Together they form a unique fingerprint.

  • Cite this