Publication: Clinical predictors and risk factors for vaginal mesh extrusion
Issued Date
2018-02-01
Resource Type
ISSN
14338726
07244983
07244983
Other identifier(s)
2-s2.0-85034776197
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Mahidol University
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SCOPUS
Bibliographic Citation
World Journal of Urology. Vol.36, No.2 (2018), 299-304
Suggested Citation
Usah Khrucharoen, Patkawat Ramart, Judy Choi, Diana Kang, Ja Hong Kim, Shlomo Raz Clinical predictors and risk factors for vaginal mesh extrusion. World Journal of Urology. Vol.36, No.2 (2018), 299-304. doi:10.1007/s00345-017-2137-y Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46987
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Title
Clinical predictors and risk factors for vaginal mesh extrusion
Abstract
© 2017, Springer-Verlag GmbH Germany, part of Springer Nature. Purposes: Our study aims to enhance the accuracy of the clinical diagnosis in patients with vaginal mesh extrusion following transvaginal mesh placement for pelvic organ prolapse using significant clinical parameters and risk factors. Methods: All patients who underwent vaginal mesh removal were retrospectively reviewed from January 2000 to May 2014. Eligible patients were divided into two groups according to the presence of vaginal mesh extrusion. Results: A total of 862 patients, 798 were included. 357 (44.7%) had evidence of vaginal mesh extrusion, and 441 (55.3%) had no evidence of vaginal mesh extrusion. The mean age of the vaginal mesh extrusion group was slightly higher than in the group without vaginal mesh extrusion (58.7 ± 11.2 vs. 56.4 ± 11.5, respectively; p = 0.002). From multivariate analysis, the significant clinical correlations for vaginal mesh extrusion were vaginal bleeding [60 (16.9) vs. 14 (3.2%), p < 0.001], hispareunia [48 (13.5) vs. 15 (3.4%), OR = 4.163, p < 0.001], and vaginal discharge [45 (12.6) vs. 18 (4.1%), p = 0.001]. The risk factors were multiple mesh implantations [218 (67.06) vs. 175 (39.68%), p < 0.001] and menopause [314 (88) vs. 364 (82.7%), p = 0.145]. Demographic data, including BMI, sexual activity, vaginal atrophy, both local and systemic hormonal use, smoking status, and hysterectomy status, were not significantly different, as well as the clinical symptoms including dyspareunia, vaginal infection, and symptomatic vaginal bulge. Conclusions: Vaginal bleeding, hispareunia, and vaginal discharge were the most significant clinical predictors for raising suspicion of vaginal mesh extrusion. Multiple mesh implantations were a significant risk factor for extrusion.