|
| Author | Trial | Number of patients | Mesh | Complications | Median time to revision | Management | Concomitant procedure | Follow-up |
|
Abbot et al.
2014 [17] | RT | 347 (49.9% MUS; 25.6% TVM or CSP; 24.2% combination) | Various | 30% dyspareunia
42.7% mesh erosion
34.6% pelvic pain
77% grade 3 or 4 (reoperation) complication | 5.8 mos (0–65.2 mos) | (1) Trimming of mesh/partial excision (50.9%)
(2) Release of mesh arms (18.1%)
(3) Complete intravaginal mesh excision (26.9%)
(4) Recurrent prolapse treatment (23.2%)
(5) Recurrent incontinence treatment (14.8%)
(6) Other surgeries (20.1%)
(7) Initial conservative treatment (23%)
60% ≥2 interventions | MUS | |
|
Agnew et al.
2012 [18] | RT | 63 MUS | Various synthetics (67% monofilament TVT, 17% TOT) | 100% voiding dysfunction | 12.4 mos (1 week–8 yrs) | (1) Simple sling division (73%)
(2) Partial excision of sling (21%)
(3) Concomitant procedure to prevent Re-SUI (4/63) | Burch, MUS | Persistent voiding dysfunction
(1) 10.9%; (2) 7.7%; (3) 50% ()
Subsequent surgery for recurrent SUI
(1) 2.2%; (2) 23.1%; (3) 0% ()
De novo urgency
(1) 10.9%; (2) 15.4%; (3) 25% () |
|
Blaivas et al.
2013 [19] | RT | 47 MUS | Type 1 76%
Types 2–3 23% | OAB (70%)
SUI (55%)
Recurrent UTI (21%)
Pelvic pain/dysuria (34%)
Obstructive symptoms (9%)
Vaginal extrusion (9%) | 2 yrs (1 mos–8 yrs) | (1) Sling excision + urethrolysis (34%)
(2) Sling excision + urethral reconstruction (including fistula repair) + autologous fascial sling (30%)
(3) Sling incision (21%)
(4) Partial cystectomy (10%)
(5) Ureteroneocystostomy (4%) | MUS | 2 yrs (0.25–12 yrs)
Successful treatment 72%
28% recurrent surgery
refractory pain (19%), mesh extrusion (17%), and OAB (8%) |
|
Costantini et al.
2011 [20] | RT | 12 (12/179, 6.7%) mesh erosion after abdominal CSP | 11 PP, 1 Gore-Tex | 100% mesh erosion
41% vaginal bleeding
33% asymptomatic
17% dyspareunia
17% infection (1x Gore-Tex) | 22.9 mos (2–66 mos) | (1) Antibiotics and local estrogen (100%)
(2) Vaginal (partial) mesh resection (83%)
(3) Abdominal resection (17%)
(4) Endoscopic (8%) | | 57 mos (18–120 mos)
(1) All needed surgery
(3) Recurrent cystocele
(4) Fistula, abdominal revision |
|
Davis et al.
2012 [21] | RT | 12 TVT | PP | 100% mesh erosion | 59 mos (7–144 mos) | Endoscopic holmium: YAG laser excision (100%) | | 65.5 mos (6–134 mos)
33% second laser excision
17% surgery for recurrent SUI
8% (1 patient) abdominal mesh resection |
|
Firoozi et al.
2012 [22] | RT | 23 TVM for POP | Various PP | Vaginal/pelvic pain (39%), dyspareunia (39%), vaginal mesh extrusion/exposure (26%), urinary incontinence (35%), recurrent pelvic organ prolapse (22%), bladder mesh perforation (22%), rectal mesh perforation (4%), ureteral perforation injury (4%), and vesicovaginal fistula (9%) | 10 mos (1–27 mos) | (1) Transvaginal excision (90%)
(2) Transvaginal/endoscopic (5%)
(3) Transrectal/transperineal (5%)
(4) Concomitant POP/SUI repair (45%) | TVM, MUS | 3 mos
14% UTI
4.3% collagen injection for Re-SUI
4.3% PFT for perineal pain |
|
|
Greiman and Kielb 2012 [23] | RT | 28 (28/118, 23%) MUS | PP | Intravesical sling (4%), extruded vaginal mesh (93%), obstructive voiding symptoms (78%), dyspareunia (42%), and vaginal bleeding (21%) | 15 mos | (1) Sling loosening, incision in the midline
(2) If mesh erosion >1 cm a resection | | 11% reoperation for mesh extrusion, no other complications |
|
Hammett et al.
2014 [24] | RT | 57 patients (26 MUS, 23 TVM, and 9 intraperitoneal prolapse CSP) | Various PP | 100% mesh erosion with pelvic pain (55.9%), dyspareunia (54.4%), and vaginal discharge (30.9%). | | (1) Vaginal mesh excision (91%)
(2) Abdominal resection (all CSP, /15, 40%) | | 6 weeks
57% symptoms completely resolved
12% required more than 1 surgery for mesh excision
(1) 9% UTI
(2) 4.5% cardiopulmonal complications; 18% sepsis; 45% wound infection |
|
Hampel et al.
2009 [25] | RT | 48 MUS (44 TVT, 4 TOT) | Various PP | De novo urge (65%), mesh erosion (21%), dyspareunia (19%), UTI (35%), and fistula (6%) | | (1) Partial mesh resection (trans-/suburethral, 23%)
(2) Self-catheterisation (23%)
(3) Botox/neuromodulation (27%)
(4) Fascia plastic (10%)
(5) Complete abdominal-vaginal mesh resection (8%)
(6) Urinary diversion (2%)
(7) Fistula repair (6%)
(8) Conservative treatment (25%) | | 42% symptoms completely resolved |
|
Kasyan et al.
2014 [15] | RT | 152 TVM | Prolift (Gynecare), PP | Erosions (21%), dyspareunia (11%), mesh shrinkage (4.4%), pelvic abscess (2.7%), and fistula (1.3%) | | (1) Conservative treatment with local oestrogen
(2) Partial/total mesh excision | | |
|
Nguyen et al.
2012 [26] | RT | 82 MUS (2.2%) | Various | | | (1) Sling loosening or transaction for voiding dysfunction (60%)
(2) Excision for vaginal mesh exposure 30 (36%)
(3) Excision for pain (1.2%)
(4) Excision for urethral erosion (1.2%)
(5) Drainage of retropubic hematoma (1.2%) | MUS, colporrhaphy, and CSP | |
|
|
Abdel-Fattah et al. 2006 [16] | RT | 34 TVM (2.2%) | Various | | | (1) Excision for vaginal mesh exposure (85%)
(2) Excision of vaginal suture (6%)
(3) Biologic graft reoperation (12%)
(4) Drainage hematoma/abscess (6%)
(5) Bowel resection for obstruction (3%) | | |
|
Padmanabhan
et al. 2012 [27] | RT | 85 (MUS, TVM) | Various PP | Perforation of urethra (14%), bladder (36%), and vagina (50%) | | (1) Vaginal excision (14%)
(2) Lower urinary tract excision (47%)
(3) Partial cystectomy (21%)
(4) Urethroplasty (21%) | | Subjective cure in 75% and improvement in 21% SUI (6.6–12.5%) |
|
Renezeder
et al. 2011 [28] | RT | 118 (80% MUS, 20% TVM) | Various PP (88% type 1) | De novo urgency (46.6%), dyspareunia (41.5%), recurrent UTI (39.0%), mesh erosion (37%), and vaginal bleeding (9.3%) | 27 mos (1–89 mos) | (1) Tissue patch covering (17.8%)
(2) Partial removal (65.3%)
(3) Complete removal per laparotomy (12.7%)
(4) Bone stabilization (0.8%)
(5) Excision of granulation tissue (3.4%) | | 8 weeks
45.5% urgency |
|
|
Ridgeway et al. 2008 [29] | RT | 19 TVM | Monofilament PP | Chronic pain (31%), dyspareunia (31%), recurrent pelvic organ prolapse (42%), mesh erosion (63%), and vesicovaginal fistula (16%) | | Partial tailored vaginal mesh resection with concomitant procedures | Burch, MUS | 33 weeks (16–75 weeks)
16% UTI
5% hematoma
21% persistent symptoms |
|
|
Rouprêt et al. 2010 [30] | RT | 38 TVT | PP | Mesh erosion/extrusion (42%), pelvic pain (39%), and obstruction (18%) | | (1) Laparoscopic (97%)
(2) Laparoscopic + vaginal (3%) | | 38 mos (2–80)
Healing and pain release (100%)
Recurrent SUI (66%) |
|
Shah et al.
2013 [31] | RT | 21 MUS | Polypropylene, type I | Urethral perforation (67%), bladder perforation (33%), fistula (19%), vaginal pain (67%), urgency (29%), incontinence (38%), obstruction (33%), dyspareunia (19%), and hematuria (24%) | 15.5 mos (1–60 mos) | (near) Total mesh excision, urinary tract reconstruction, and concomitant pubovaginal sling with autologous rectus fascia | MUS, urethroplasty | 22 mos (6–98 mos)
Continence (81%)
Incisional seroma (9.5%)
Additional procedures (36%)
UTI (9.5%)
Pelvic pain (9.5%)
dyspareunia 9.5% |
|
