Abstract: PD17-10
Sources of Funding: None

Introduction

There is much data in the literature about the complications of vaginal mesh; however, there is much less addressing the clinical outcomes for patients who undergo vaginal mesh removal due to complications from their mesh. The objective of this study is to describe the clinical history leading up to as well as the outcomes after vaginal mesh removal surgery at an academic, tertiary care hospital.

Methods

A retrospective study of patients who underwent vaginal mesh removal from 2008 to 2015. Demographics, clinical history, physical exam, pre- and post-operative symptoms, and number of re-operations were abstracted. Fisher&[prime]s exact test with significance at p<0.05 was used for comparative statistics.

Results

Between February 2008 and November 2015, 84 patients underwent vaginal mesh removal at our hospital. The median time interval from initial mesh placement to removal was 58 months (range 0.4 to 154 months). Most patients (n=61, 73%) had no prior history of mesh removal surgery. The most common pre-operative symptoms were vaginal pain (n=52, 62%), dyspareunia (n= 46, 55%), and pelvic pain (n=42, 50%). Intraoperative complications were infrequent with injury to the urethra, bladder, and bowel occurring in 1 patient each (n=3, 4%). Of patients presenting for follow up within 4-6 weeks post-operatively, 45 (83%) were deemed better than before surgery. Pre-operative symptoms that improved by six weeks or greater following mesh removal surgery were mesh erosion (p<.0001), vaginal pain (p<.0001), vaginal bleeding (p=0.0028), vaginal discharge (p=0.0127), dyspareunia (p=0.0024), and pelvic pain (p=0.0005). There were no identifiable risk factors to predict which patients would have persistent post-operative symptoms or who would require more than one mesh removal surgery. After vaginal mesh removal, 29 patients (35%) required one or more re-operations with 3 being the highest number of reoperations.

Conclusions

Vaginal mesh removal surgery is safe and can alleviate many pre-operative symptoms. Some patients require more than one procedure and the risk factors for reoperations are unclear.

Funding

None