• Obstetrics and gynecology · Mar 2020

    Long-term Device Outcomes of Mesh Implants in Pelvic Organ Prolapse Repairs.

    • Bilal Chughtai, Jialin Mao, Tirsit S Asfaw, Carl Heneghan, Charles R Rardin, and Art Sedrakyan.
    • Departments of Urology, Healthcare Policy and Research, and Obstetrics and Gynecology, Weill Cornell Medical College-New York Presbyterian, New York, New York; the Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom; and the Division of Urogynecology, the Warren Alpert Medical School of Brown University, and Women & Infants Hospital, Providence, Rhode Island.
    • Obstet Gynecol. 2020 Mar 1; 135 (3): 591-598.

    ObjectiveTo evaluate the longer-term safety and reintervention outcomes of mesh implants in pelvic organ prolapse (POP) repairs.MethodsWe conducted a population-based cohort study of women undergoing POP repairs in inpatient and outpatient surgical settings between 2008 and 2016 in New York State. Multivariable logistic regression was used based on patient and procedural characteristics and hospital volume between mesh and nonmesh groups to obtain propensity scores for each individual. Long-term safety events and reinterventions were assessed using time-to-event analysis.ResultsWe identified 54,194 women undergoing POP repairs (12,989 with mesh, and 41,205 without mesh). Mean age was 59.8 (±13.1) years, and median follow-up was 4.7 years (interquartile range, 2.4-6.8 years). In the propensity score-matched 12,284 pairs of women, POP repair with mesh was associated with a higher risk of reintervention when compared with POP repair without transvaginal mesh (hazard ratio 1.40, 95% CI 1.27-1.54, P<.001). The estimated risk of undergoing a reintervention at 5 years was 8.8% (95% CI 8.2-9.3%) in the mesh group and 6.3% (5.9-6.8%) in the nonmesh group. Among patients who had reinterventions, 18.5% of those operated with mesh had a reintervention related to mesh-related complications.ConclusionEven though transvaginal mesh has been removed from the market, the risk of mesh complications did not diminish over time and these women warrant close follow-up. Continued surveillance of mesh in POP repairs is essential to ensure safety for the women who have already been implanted.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…