Functional outcomes of synthetic tape and mesh revision surgeries: a monocentric experience

Int Urogynecol J. 2019 May;30(5):805-813. doi: 10.1007/s00192-018-3727-y. Epub 2018 Aug 1.

Abstract

Introduction and hypothesis: Synthetic tapes and meshes used for the treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can lead to complications that require additional surgical procedures. The objective of this study was to report the functional outcomes following tape/mesh removal procedures.

Methods: This retrospective study included all consecutive women who underwent a tape/mesh surgical revision in a single tertiary referral center from January 2008 to September 2016. Descriptive statistics were performed to assess outcomes.

Results: Overall 140 women, with a mean age of 60.5 (range 35-91) years, had a tape/mesh surgical revision. Patients underwent the following surgeries: tape removal (n = 95/140, 67.9%), tape division (n = 23/140, 16.4%), mesh removal (n = 18/140, 12.9%) and concomitant tape and mesh removal (n = 4/140, 2.9%). Tape removals were mainly performed for voiding symptoms (n = 34/95, 35.8%) and vaginal erosion/extrusion (n = 16/95, 16.8%). Most mesh removals were performed for vaginal erosion/extrusion (n = 9/18, 50.0%). Mean interval between tape/mesh insertion and its surgical revision was 52.1 months (range 5.0 days-16.0 years). Mean follow-up time was 20.4 months (range 6.0 days-7.8 years). Voiding and storage symptoms resolved completely in 37/59 (62.7%) patients and in 14/37 (37.8%) patients, respectively; 42/81 (51.9%) patients with postoperative SUI recurrence or persistence underwent an additional surgical procedure. Among the 18 patients who had a mesh removal, only 1 (5.6%) had POP recurrence.

Conclusion: Although most symptoms resolved after tape and mesh surgical revisions, patients must be informed that symptoms may persist. Recurrent or persistent SUI or POP may require a subsequent surgical procedure.

Keywords: Mesh; Pain; Prolapse; Stress urinary incontinence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Device Removal / statistics & numerical data
  • Female
  • Humans
  • Middle Aged
  • Pelvic Organ Prolapse / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Suburethral Slings / adverse effects*
  • Surgical Mesh / adverse effects*
  • Treatment Outcome
  • Urinary Incontinence, Stress / surgery*