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The analysis of 42 mesh erosion cases in 1036 cases of pelvic reconstructive surgery by mesh-replacement materials
Authors: Yan Li, Jichun Li
Number of views: 171
The objective of this study is to analyze the 42 cases of mesh erosion in total 1036 female pelvic flood dysfunction (FPFD) patients who accepted the Pelvic Reconstructive Surgery by mesh-replacement materials. 1036 patients who received pelvic organ reconstructive surgery from June, 2006 to Jan, 2015 were reviewed, including general condition, surgery records, in-patient conditions and follow up. The follow up time ranged from 3 to106 months, with the average time of 45.8±2.9 months. The erosion rate was 4.05 % (42/1036). The erosion took place from 1 to 48 months after surgery. The mean time of erosion took placed was 11.4±2.8 months. There were no significant differences in patients’ age, times of pregnancy, whether menopause, whether replacement therapy (RT) and the stage of POP and SUI, however the rate of erosion is slightly higher in patients with ages ranging from 50s to 60s. No erosion case was found in the simple TVT-O group. There was no significant difference between TVH altogether and no TVH (P>0.05). There was no significant difference with or without TVT-O together (P>0.05), but the rate in total pelvic reconstruction is obviously higher than anterior pelvic construction surgery (P<0.05). In total 42 cases, 71.4% (30/42) happened in anterior vaginal wall, 21.4% (9/42) happened in posterior vaginal wall, 4.8% (2/42) happened in both anterior and posterior vaginal wall. 2.4% (1/42) happened in the puncture path of the two thigh root. The erosion rate in anterior vaginal wall is obviously higher than posterior wall (P<0.05). There were no erosion happened in bladder or rectum. In all 42 erosion cases, 80.9% (34/42) had vaginitis (include acute and chronic). In conclusion, most erosion happened in the vaginal wall, especially the anterior vaginal wall. The best therapy for mesh erosion is to remove the mesh by surgery. Infection is the main cause of erosion post operatively.