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Am J Obstet Gynecol. 2009 Jul;201(1):73.e1-7. doi: 10.1016/j.ajog.2009.02.028. Epub 2009 Apr 23.

De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair.

Author information

1
Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Walter Reed Army Medical Center, Washington, DC, USA. Matt.Aungst@yahoo.com

Abstract

OBJECTIVE:

We sought to determine the rate of de novo stress incontinence, pelvic muscle symptoms, mesh exposure, visceral injury rate, and recurrent prolapse after transvaginal mesh repair.

STUDY DESIGN:

We conducted a retrospective review of 335 consecutive women with stage II or worse vaginal prolapse who underwent Prolift (Ethicon, Somerville, NJ) between July 7, 2005 and Jan. 31, 2008.

RESULTS:

In all, 71% underwent total Prolift, 20% anterior, and 8% posterior alone. Average age was 62 years and mean follow-up was 8 months. The intraoperative visceral injury rate was 6.6%, mesh exposure rate was 3.8%, and recurrent failure rate was 5.2%. The postoperative de novo stress incontinence rate was 24.3%. In this series, 18% of women had pelvic muscle symptoms postoperatively; 74% of these resolved within 6 months with conservative management.

CONCLUSION:

After Prolift, surgeons can expect a low rate of recurrent prolapse and mesh exposure. However, pelvic muscle dysfunction and de novo stress incontinence will be encountered postoperatively in a moderate number of women.

PMID:
19393596
DOI:
10.1016/j.ajog.2009.02.028
[Indexed for MEDLINE]

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