首页|Efficacy and safety of transvaginal mesh repair in a cohort with a minimum of 10-year follow-up

Efficacy and safety of transvaginal mesh repair in a cohort with a minimum of 10-year follow-up

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Although transvaginal mesh(TVM)repair is no longer used in some countries,long-term outcomes after TVM surgery are of great im-portance globally.However,reports with follow-up＞10 years are limited.Thus,this study aimed to report outcomes in a prospective cohort with at least 10 years of follow-up.Women with stage Ⅲ-Ⅳ symptomatic prolapse were approached consecutively from 2008 to 2013 at one tertiary hospital.The main outcome measure was symptomatic failure.Secondary outcomes included anatomic failure,recurrence,patient satisfaction,complications,and reoperation.The Kaplan-Meier curve was used to estimate the cumulative failure rate.Of the 121 patients enrolled in the study,103(85.1％)completed a median follow-up of 11 years.The estimated probability rates of symptomatic and anatomic failure were 17.6％and 8.8％in 11 years,respectively.The estimated incidence of symptomatic failure increased by 8.2％between 5 and 11 years;however,the corresponding rate for anatomic failure was 3.7％.The most common complication was vaginal mesh exposure,and its estimated probability increased from 19.3％to 28.4％from 5 to 11 years,respectively.Office trimming resolved 80.0％of vaginal exposures.These patients did not report decreased overall satisfaction.Patients with vaginal mesh exposure requiring＞3 office procedures or mesh removal in the operating room(5.8％by 11 years)had lower satisfaction rates(P＜0.01)and were defined as having severe mesh exposure.The rates of postoperative pain,reoperation,and Patient Global Impression of Improvement ≥2 were 2.5％,3.3％,and 94.2％,respectively.The results of this study implied that TVM treatment gradually increased the symptomatic failure rate but provided durable anatomical support of the vaginal wall.Vaginal mesh exposure was common in women who were largely not sexually active;however,80％of the cases could be managed in the outpatient clinic,which did not affect patient satisfaction.

complicationefficacylong-term follow-uppelvic organ prolapsesafetytransvaginal mesh

Zhibo Zhang、Jianbin Guo、Weijie Tian、Ye Zhang、Yuelun Zhang、Tianshu Sun、Jiali Duan、Xinmiao Bao、Yuan Wang、Yang Ye、Qianqian Gao、Honghui Shi、Abraham Nick Morse、Juan Chen、Lan Zhu

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Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,National Clinical Research Center for Obstetric and Gynecologic Diseases,Beijing 100730,China

Department of Gynecology,Guizhou Provincial People's Hospital,Medical College of Guizhou University,Guiyang 550002,China

Department of Obstetrics and Gynecology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China

Medical Research Center,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China

Medical Doctor Program,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China

Department of Pathology,Peking Union Medical College Hospital,Beijing 100730,China

Tufts University School of Medicine,Boston MA 02111,USA

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National Natural Science Foundation of ChinaNational Natural Science Foundation of ChinaNational High Level Hospital Clinical Research FundingNational High Level Hospital Clinical Research FundingNational Key Research and Development Program of ChinaNonprofit Central Research Institute Fund of Chinese Academy of Medical Sciences

81830043817715612022-PUMCH-A-1132022-PUMCH-C-0312018YFC20022012020-PT320-003

2024

10.1007/s11427-023-2508-x

中国科学:生命科学(英文版)
中国科学院

中国科学:生命科学(英文版)

CSTPCD
影响因子：0.806
ISSN：1674-7305
年,卷(期)：2024.67(5)