Mesh Excision: Is Total Mesh Excision Necessary?

Current Urology Reports
Gillian F WolffRyan M Krlin

Abstract

Nearly 29% of women will undergo a secondary, repeat operation for pelvic organ prolapse (POP) symptom recurrence following a primary repair, as reported by Abbott et al. (Am J Obstet Gynecol 210:163.e1-163.e1, 2014). In efforts to decrease the rates of failure, graft materials have been utilized to augment transvaginal repairs. Following the success of using polypropylene mesh (PPM) for stress urinary incontinence (SUI), the use of PPM in the transvaginal repair of POP increased. However, in recent years, significant concerns have been raised about the safety of PPM mesh. Complications, some specific to mesh, such as exposures, erosion, dyspareunia, and pelvic pain, have been reported with increased frequency. In the current literature, there is not substantive evidence to suggest that PPM has intrinsic properties that warrant total mesh removal in the absence of complications. There are a number of complications that can occur after transvaginal mesh placement that do warrant surgical intervention after failure of conservative therapy. In aggregate, there are no high-quality controlled studies that clearly demonstrate that total mesh removal is consistently more likely to achieve pain reduction. In the cases of obstruction an...Continue Reading

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Citations

Mar 8, 2017·The Journal of Urology·Nirmish SinglaPhilippe E Zimmern
Jun 9, 2016·Current Opinion in Obstetrics & Gynecology·Lisa Rogo-Gupta, Mario Castellanos
Aug 6, 2020·Therapeutic Advances in Urology·Paulina Bueno Garcia Reyes, Hashim Hashim
Jul 22, 2016·Current Urology Reports·Seth A Cohen, Howard B Goldman
Jul 2, 2019·Arab Journal of Urology·Andrew BergersenChristian O Twiss
Oct 10, 2020·International Urogynecology Journal·Claudia R KowalikJan-Paul W R Roovers
Nov 20, 2020·Female Pelvic Medicine & Reconstructive Surgery·Jorge L FuentesPhilippe E Zimmern
May 27, 2021·International Urogynecology Journal·Tsia-Shu LoYi-Pin Chen

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