Back to Search Start Over

Prediction of successful revision surgery for mesh-related complaints after inguinal hernia and pelvic organ prolapse repair.

Prediction of successful revision surgery for mesh-related complaints after inguinal hernia and pelvic organ prolapse repair.

Authors :
Van Rest KLC
Gielen MJCAM
Warmerdam LM
Kowalik CR
Roovers JPWR
Zwaans WAR
Source :
Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2024 Apr; Vol. 28 (2), pp. 401-410. Date of Electronic Publication: 2023 Feb 08.
Publication Year :
2024

Abstract

Purpose: With this retrospective case series, we aim to identify predictors for reduction of pain after mesh revision surgery in patients operated for inguinal hernia or pelvic organ prolapse with a polypropylene implant. Identifying these predictors may aid surgeons to counsel patients and select appropriate candidates for mesh revision surgery.<br />Methods: Clinical records before and after mesh revision surgery from 221 patients with chronic postoperative inguinal pain (CPIP) and 59 patients with pain after pelvic organ prolapse (POP) surgery were collected at two experienced tertiary referral centers. Primary outcome was patient reported improvement of pain after revision surgery. A multivariable logistic regression model was used to specify predictors for pain reduction.<br />Results: The multivariable logistic regression was performed for each patient group separately. Patients with CPIP had higher chances of improvement of pain when time between mesh placement and mesh revision surgery was longer, with an OR of 1.19 per year. A turning point in chances of risks and benefits was demonstrated at 70 months, with improved outcomes for patients with revision surgery ≥ 70 months (OR 2.86). For POP patients, no statistically significant predictors for reduction of pain after (partial) removal surgery could be identified.<br />Conclusion: A longer duration of at least 70 months between implantation of inguinal mesh and revision surgery seems to give a higher chance on improvement of pain. Caregivers should not avoid surgery based on a longer duration of symptoms when an association between symptoms and the location of the mesh is found.<br /> (© 2023. The Author(s).)

Details

Language :
English
ISSN :
1248-9204
Volume :
28
Issue :
2
Database :
MEDLINE
Journal :
Hernia : the journal of hernias and abdominal wall surgery
Publication Type :
Academic Journal
Accession number :
36753034
Full Text :
https://doi.org/10.1007/s10029-023-02748-5