1. Complications after pelvic floor repair surgery (with and without mesh): short-term incidence after 1873 inclusions in the French VIGI-MESH registry.
- Author
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Fritel X, Campagne-Loiseau S, Cosson M, Ferry P, Saussine C, Lucot JP, Salet-Lizee D, Barussaud ML, Boisramé T, Carlier-Guérin C, Charles T, Debodinance P, Deffieux X, Pizzoferrato AC, Curinier S, Ragot S, Ringa V, de Tayrac R, and Fauconnier A
- Subjects
- Adult, Aged, Aged, 80 and over, Analysis of Variance, Colposcopy adverse effects, Colposcopy mortality, Colposcopy statistics & numerical data, Female, France epidemiology, Humans, Incidence, Intraoperative Complications etiology, Intraoperative Complications mortality, Middle Aged, Pelvic Organ Prolapse mortality, Postoperative Complications etiology, Postoperative Complications mortality, Prospective Studies, Registries, Suburethral Slings adverse effects, Suburethral Slings statistics & numerical data, Surgical Mesh statistics & numerical data, Surgicenters statistics & numerical data, Young Adult, Pelvic Floor surgery, Pelvic Organ Prolapse surgery, Surgical Mesh adverse effects
- Abstract
Objective: To assess the short-term incidence of serious complications of surgery for urinary incontinence or pelvic organ prolapse., Design: Prospective longitudinal cohort study using a surgical registry., Setting: Thirteen public hospitals in France., Population: A cohort of 1873 women undergoing surgery between February 2017 and August 2018., Methods: Preliminary analysis of serious complications after a mean follow-up of 7 months (0-18 months), according to type of surgery. Surgeons reported procedures and complications, which were verified by the hospitals' information systems., Main Outcome Measures: Serious complication requiring discontinuation of the procedure or subsequent surgical intervention, life-threatening complication requiring resuscitation, or death., Results: Fifty-two women (2.8%, 95% CI 2.1-3.6%) experienced a serious complication either during surgery, requiring the discontinuation of the procedure, or during the first months of follow-up, necessitating a subsequent reoperation. One woman also required resuscitation; no women died. Of 811 midurethral slings (MUSs), 11 were removed in part or totally (1.4%, 0.7-2.3%), as were two of 391 transvaginal meshes (0.5%, 0.1-1.6%), and four of 611 laparoscopically placed mesh implants (0.7%, 0.2-1.5%). The incidence of serious complications 6 months after the surgical procedure was estimated to be around 3.5% (2.0-5.0%) after MUS alone, 7.0% (2.8-11.3%) after MUS with prolapse surgery, 1.7% (0.0-3.8%) after vaginal native tissue repair, 2.8% (0.9-4.6%) after transvaginal mesh, and 1.0% (0.1-1.9%) after laparoscopy with mesh., Conclusions: Early serious complications are relatively rare. Monitoring must be continued and expanded to assess the long-term risk associated with mesh use and to identify its risk factors., Tweetable Abstract: Short-term serious complications are rare after surgery for urinary incontinence or pelvic organ prolapse, even with mesh., (© 2019 Royal College of Obstetricians and Gynaecologists.)
- Published
- 2020
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