PD24-06 EXCISION OF PELVIC FLOOR MESH VIA AN ABDOMINAL APPROACH HAS A HIGH SUCCESS RATE AND LONG-TERM PATIENT SATISFACTION

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Pelvic Organ Prolapse and Reconstructive Surgery (Including Non-trauma Related Fistula and Urethral Diverticulum) (PD24)1 May 2024PD24-06 EXCISION OF PELVIC FLOOR MESH VIA AN ABDOMINAL APPROACH HAS A HIGH SUCCESS RATE AND LONG-TERM PATIENT SATISFACTION Sabrina L. Stair, Jennifer Chyu, Cristina Palmer, Alvaro Lucioni, and Una Lee Sabrina L. StairSabrina L. Stair , Jennifer ChyuJennifer Chyu , Cristina PalmerCristina Palmer , Alvaro LucioniAlvaro Lucioni , and Una LeeUna Lee View All Author Informationhttps://doi.org/10.1097/01.JU.0001008840.07763.8d.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pain and mesh erosion are known complications of pelvic floor surgery using polypropylene mesh. Data on contemporary outcomes of abdominal surgical management of mesh complications is limited. The objective of this study was to examine contemporary surgical outcomes and patient satisfaction rates of mesh excision via an abdominal approach, both robotically and open. METHODS: Retrospective chart review was performed of patients identified by CPT code 57296 (abdominal excision of mesh) from 2010 to 2022 at a single tertiary care institution. Inclusion criteria were women who had open abdominal or robotic excision of mesh for treatment of pain and/or mesh erosion. Patients with mesh excised incidentally or of non-mesh products were excluded. Surgical success was defined as 1) no reoperation for primary presenting symptoms and 2) improvement or resolution in primary presenting symptoms. Patient satisfaction was assessed using the patient global improvement index (PGI-I) and institutional post-operative questionnaires. RESULTS: 32 women had the following primary pelvic floor surgeries using mesh. Results are summarized in Table 1. 27 had mesh sacrocolpopexy, 5 had mesh slings, and 1 had transvaginal placed mesh. 17 bladder, 2 ureteral, 13 vaginal, and 2 bowel mesh erosions requiring excision and repair were identified. 4 patients underwent excision for pain without mesh erosion. 16 had robotic and 18 had open mesh removal surgery. At mean follow-up of 33.5 (SD 35.5) months, 84% (27/32) met the definition of surgical success. All patients (4/4) who underwent mesh excision for pain alone had significant improvement in pain. 1 (3.1%) required additional mesh excision surgery, and 6 (18.8%) had subsequent prolapse surgery. Complications included ureteral injury (1), bowel injury (1) and wound infection (1), that were managed operatively. At a mean follow-up of 49 (SD 31.6) months, patients (n=18) reported a median of 80% improvement on the PGI-I (IQR 55-100) with an average satisfaction of 9/10 (SD 1.72). CONCLUSIONS: In the subset of women with mesh erosion and/or pain which are surgically managed from the abdominal approach, robotic or open, medium term follow up demonstrates a high rate of success and high patient-reported satisfaction. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e532 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sabrina L. Stair More articles by this author Jennifer Chyu More articles by this author Cristina Palmer More articles by this author Alvaro Lucioni More articles by this author Una Lee More articles by this author Expand All Advertisement PDF downloadLoading ...