Background and importance Over the past decade, there have been many discussions about vaginal mesh used for transvaginal repair of pelvic organ prolapse and the complications related to mesh procedures. It appears that mesh products probably entered the marked with too little information on their safety. On 16 April 2019, the FDA asked for immediate withdrawal of mesh used in the USA in these surgical procedures. Our country was affected by the same mesh withdrawals and the few mesh prostheses still marketed, reclassified as class III devices, are currently being re-evaluated. Even though very few mesh complications have been reported and despite the known side effects, some gynaecologists maintain there is need for such devices.
Aim and objectives Our study was a retrospective analysis of the records of patients treated for transvaginal prolapse of the pelvic organs by Ingynious prosthesis (AMI, Austria), mesh authorised and used in our hospital.
Material and methods The records of patients who underwent procedures between January 2017 and July 2019 were analysed. Justification for prosthesis placement, complications and post-surgery follow-up were analysed.
Results The average age of the 28 patients was 69.8 years and average BMI was 25 kg/m2. Mesh placement decision was guided by patient risk factors (multiple surgeries, obesity, advanced age) in conjunction with risks linked to general anaesthesia. Ten patients (35.7%) had suffered from pelvic prolapse recurrence, five after promotofixation and five after the use of pessaries. The only peroperative complications reported were two cases of bladder injury. Two cases of mesh over tension were described, and one required reoperation 2 days later. At that time, no serious complications were reported except a mesh cut detected a few days after placement, leading to a new procedure.
Conclusion and relevance This retrospective study confirmed vaginal meshes are used in well defined circumstances when promotofixation is contraindicated. This work needs to be continued to identify late complications. such as erosion. It is not known whether our regulatory authorities will continue to allow the use of these devices. However, when used wisely, according to each patient’s history and by experienced surgeons, vaginal mesh placement is still an option to be considered.
References and/or acknowledgements No conflict of interest.
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