Abstract
Objectives: The aim of this study is to identify risk factors for vaginal mesh exposure after mesh-augmented repair of anterior prolapse. Methods: We performed a retrospective cohort study of all patients who had mesh-augmented anterior repair by 1 surgeon between January 2007 and February 2012. Data were extracted from medical records. The primary outcome was the rate of anterior or apical vaginal mesh exposure. Both univariate and multivariate analyses were performed. Results: A total of 201 subjects were included. Themean (SD) follow-up was 14.3 (12.4) months. All cases were done using a type 1 macroporous monofilament polypropylene mesh. The overall mesh exposure rate was 8.5% (17/201). Univariate analysis showed a statistically significant positive association between exposure rates and the following risk factors: lower body mass index (BMI) (P = 0.016), menopause in combination with the use of hormone replacement therapy (P = 0.023), midline sagittal vaginal incision (compared with distal transverse incision) (P = 0.026), concurrent total hysterectomy (P G 0.001), surgery time (P = 0.002), and worse apical prolapse at baseline (P = 0.007). After multivariate analysis using logistic regression, only BMI (P G 0.001) and concomitant total hysterectomy (odds ratio, 48; P G 0.001) remained relevant. The exposure rate was 23.5% (16/68) when concomitant hysterectomy was performed compared with 0.8% (1/133) when no hysterectomy was done. Exposure rates stratified by BMI class were 12.9% (8/62) for BMI less than 25 kg/m2, 9.5% (8/84) for BMI of 25 to 29.9 kg/m2, 3.1% (1/32) for BMI of 30 to 34.9 kg/m2, and 0% (0/23) for BMI greater than or equal to 35 kg/m2. Conclusions: Concomitant total hysterectomy is an independent risk factor for mesh exposure after mesh-augmented anterior repair, whereas BMI may negatively correlate with exposure rates.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 305-309 |
| Number of pages | 5 |
| Journal | Female Pelvic Medicine and Reconstructive Surgery |
| Volume | 20 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2014 |
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Keywords
- Exposure
- Mesh
- Pelvic organ prolapse
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Surgery
- Urology
Cite this
Risk factors for vaginal mesh exposure after mesh-augmented anterior repair : A retrospective cohort study. / El-Khawand, Dominique; Wehbe, Salim A.; O'Hare, Peter G.; Arunachalam, Divya; Vakili, Babak.
In: Female Pelvic Medicine and Reconstructive Surgery, Vol. 20, No. 6, 2014, p. 305-309.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk factors for vaginal mesh exposure after mesh-augmented anterior repair
T2 - A retrospective cohort study
AU - El-Khawand, Dominique
AU - Wehbe, Salim A.
AU - O'Hare, Peter G.
AU - Arunachalam, Divya
AU - Vakili, Babak
PY - 2014
Y1 - 2014
N2 - Objectives: The aim of this study is to identify risk factors for vaginal mesh exposure after mesh-augmented repair of anterior prolapse. Methods: We performed a retrospective cohort study of all patients who had mesh-augmented anterior repair by 1 surgeon between January 2007 and February 2012. Data were extracted from medical records. The primary outcome was the rate of anterior or apical vaginal mesh exposure. Both univariate and multivariate analyses were performed. Results: A total of 201 subjects were included. Themean (SD) follow-up was 14.3 (12.4) months. All cases were done using a type 1 macroporous monofilament polypropylene mesh. The overall mesh exposure rate was 8.5% (17/201). Univariate analysis showed a statistically significant positive association between exposure rates and the following risk factors: lower body mass index (BMI) (P = 0.016), menopause in combination with the use of hormone replacement therapy (P = 0.023), midline sagittal vaginal incision (compared with distal transverse incision) (P = 0.026), concurrent total hysterectomy (P G 0.001), surgery time (P = 0.002), and worse apical prolapse at baseline (P = 0.007). After multivariate analysis using logistic regression, only BMI (P G 0.001) and concomitant total hysterectomy (odds ratio, 48; P G 0.001) remained relevant. The exposure rate was 23.5% (16/68) when concomitant hysterectomy was performed compared with 0.8% (1/133) when no hysterectomy was done. Exposure rates stratified by BMI class were 12.9% (8/62) for BMI less than 25 kg/m2, 9.5% (8/84) for BMI of 25 to 29.9 kg/m2, 3.1% (1/32) for BMI of 30 to 34.9 kg/m2, and 0% (0/23) for BMI greater than or equal to 35 kg/m2. Conclusions: Concomitant total hysterectomy is an independent risk factor for mesh exposure after mesh-augmented anterior repair, whereas BMI may negatively correlate with exposure rates.
AB - Objectives: The aim of this study is to identify risk factors for vaginal mesh exposure after mesh-augmented repair of anterior prolapse. Methods: We performed a retrospective cohort study of all patients who had mesh-augmented anterior repair by 1 surgeon between January 2007 and February 2012. Data were extracted from medical records. The primary outcome was the rate of anterior or apical vaginal mesh exposure. Both univariate and multivariate analyses were performed. Results: A total of 201 subjects were included. Themean (SD) follow-up was 14.3 (12.4) months. All cases were done using a type 1 macroporous monofilament polypropylene mesh. The overall mesh exposure rate was 8.5% (17/201). Univariate analysis showed a statistically significant positive association between exposure rates and the following risk factors: lower body mass index (BMI) (P = 0.016), menopause in combination with the use of hormone replacement therapy (P = 0.023), midline sagittal vaginal incision (compared with distal transverse incision) (P = 0.026), concurrent total hysterectomy (P G 0.001), surgery time (P = 0.002), and worse apical prolapse at baseline (P = 0.007). After multivariate analysis using logistic regression, only BMI (P G 0.001) and concomitant total hysterectomy (odds ratio, 48; P G 0.001) remained relevant. The exposure rate was 23.5% (16/68) when concomitant hysterectomy was performed compared with 0.8% (1/133) when no hysterectomy was done. Exposure rates stratified by BMI class were 12.9% (8/62) for BMI less than 25 kg/m2, 9.5% (8/84) for BMI of 25 to 29.9 kg/m2, 3.1% (1/32) for BMI of 30 to 34.9 kg/m2, and 0% (0/23) for BMI greater than or equal to 35 kg/m2. Conclusions: Concomitant total hysterectomy is an independent risk factor for mesh exposure after mesh-augmented anterior repair, whereas BMI may negatively correlate with exposure rates.
KW - Exposure
KW - Mesh
KW - Pelvic organ prolapse
UR - http://www.scopus.com/inward/record.url?scp=84928105418&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928105418&partnerID=8YFLogxK
U2 - 10.1097/SPV.0000000000000095
DO - 10.1097/SPV.0000000000000095
M3 - Article
C2 - 25185633
AN - SCOPUS:84928105418
VL - 20
SP - 305
EP - 309
JO - Female Pelvic Medicine and Reconstructive Surgery
JF - Female Pelvic Medicine and Reconstructive Surgery
SN - 2151-8378
IS - 6
ER -