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Exploring predictors of mesh exposure after vaginal prolapse repair.
- Source :
-
Female pelvic medicine & reconstructive surgery [Female Pelvic Med Reconstr Surg] 2013 Jul-Aug; Vol. 19 (4), pp. 206-9. - Publication Year :
- 2013
-
Abstract
- Objectives: To evaluate clinical, demographic, and surgical factors that may be associated with mesh exposure after vaginal repair of pelvic organ prolapse (POP).<br />Methods: Records of women who underwent POP repair with Elevate or Prolift were retrospectively reviewed. Body mass index (BMI), prolapse grade, smoking history, diabetes, steroid and estrogen use, parity, compartment repaired, concurrent hysterectomy, operative time, postoperative pain, change in hemoglobin (ΔHgb) and other characteristics were evaluated for associations with mesh exposure.Categorical variables were examined using Pearson χ test where appropriate, or the Fisher exact test was used. The continuous variables were examined using Wilcoxon rank tests. A multivariable logistic regression analysis was completed to examine predictors of mesh exposure. All analyses used SAS for Windows version 9.2 (Cary, NC).<br />Results: Three hundred thirty-five women underwent repair from 2006 to 2011. Vaginal mesh exposure was identified in 27 (8.1%) of the 335 women. Patients with exposure had longer median follow-up than the group with no exposure (357 vs 145 days; P = 0.0003). The median time to exposure was 96 days (15-1129 days). Mesh exposure was associated with lower BMI (25.2 ± 2.5 vs 27.4 ± 5.1; P = 0.020) and greater ΔHgb (-3.7 ± 1.7 mg/dL vs -2.5 ±1.3; P = 0.0011). Change in hemoglobin decreased over time (P = 0.0005). Exposure rates also decreased over time (17% in 2005 to 12% in 2006, then 5%-8% in 2006-2011) but were not statistically significant (P = 0.49).<br />Conclusions: In this study, vaginal mesh exposure was only associated with ΔHgb and lower BMI.
- Subjects :
- Aged
Body Mass Index
Clinical Competence
Female
Hemoglobins metabolism
Humans
Middle Aged
Patient Selection
Practice Patterns, Physicians'
Recurrence
Retrospective Studies
Risk Factors
Surgical Mesh adverse effects
Uterine Prolapse diagnosis
Surgical Mesh statistics & numerical data
Uterine Prolapse etiology
Uterine Prolapse surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2151-8378
- Volume :
- 19
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Female pelvic medicine & reconstructive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 23797518
- Full Text :
- https://doi.org/10.1097/SPV.0b013e318298b381