Department of Theology and Religion, University of Otago, Otago, New Zealand.
Int Urogynecol J. 2020 Apr;31(4):823-829. doi: 10.1007/s00192-019-04155-w. Epub 2019 Dec 4.
This research sought to address a gap in the literature about women's lived experience of pelvic surgical mesh complications, conducted by an insider researcher. An increasing number of women who have pelvic mesh surgeries with a view to improving their lives are experiencing life-altering complications. Without knowledge of these experiences we cannot know how best to care for affected women and prevent harm to further women.
Van Manen's hermeneutic phenomenological method was used. Seven women with pelvic mesh complications aged 43-69 years were enrolled using criterion sampling. Four of the seven women had surgical mesh for both pelvic organ prolapse (POP) and stress urinary incontinence (SUI), one for POP only, and two for SUI only. The women completed a modified ICIQ-LUTSqol questionnaire pre-interview and answered a separate global spiritual question adapted from the HOPE tool, a framework for spiritual assessment. Women were interviewed once using a semi-structured approach. Data were analysed using Van Manen's selective reading technique and organized according to Lifeworld Existentials.
Modified ICIQ-LUTSqol scores ranged between 43 and 76 (range 19-76), with a mean of 62.2 (SD + 10.011) demonstrating significant impact on quality of life. Themes emerging from the analysis were: (1) lived space: 1(a) feeling powerless in the medical space, 1(b) living in a shrinking world; (2) lived body: 2(a) living with unrelenting pain, 2(b) inhabiting a body that can no longer be relied on; (3) lived time: 3(a) living in the gap between what was and what could have been; (4) lived other: 4(a) suffering in silence, 4(b) finding absolute Other and others as a source of strength.
Pelvic surgical mesh complications have an extensive adverse impact on the lifeworld of women experiencing complications. Failure to acknowledge mesh complications as treatment injury stalls the development of safer alternatives and changes needed to industry practices, regulation, clinical practice, and monitoring to keep women undergoing innovative urogynaecological procedures safe.
本研究旨在通过内部研究人员填补有关女性盆腔手术网片并发症的生活体验的文献空白。越来越多的女性接受盆腔网片手术以改善生活质量，但她们却经历着改变生活的并发症。如果我们不了解这些经历，就无法知道如何最好地照顾受影响的女性，并防止更多女性受到伤害。
采用范·梅南的解释现象学方法。使用标准抽样法招募了 7 名年龄在 43-69 岁之间患有盆腔网片并发症的女性。这 7 名女性中有 4 名患有盆腔器官脱垂（POP）和压力性尿失禁（SUI），1 名仅患有 POP，2 名仅患有 SUI。在接受访谈前，所有女性均完成了改良的 ICIQ-LUTSqol 问卷，并回答了一个来自 HOPE 工具（一种精神评估框架）的单独的全球性精神问题。女性使用半结构化方法接受了一次访谈。数据使用范·梅南的选择性阅读技术进行分析，并根据生活世界存在主义进行组织。
改良的 ICIQ-LUTSqol 评分范围为 43-76 分（范围为 19-76 分），平均得分为 62.2（标准差+10.011），表明对生活质量有显著影响。分析中出现的主题包括：（1）生活空间：1（a）在医疗空间中感到无能为力，1（b）生活在一个不断缩小的世界中；（2）生活身体：2（a）生活在无法缓解的疼痛中，2（b）居住在无法再依赖的身体中；（3）生活时间：3（a）生活在过去和未来之间的差距中；（4）生活其他：4（a）默默承受痛苦，4（b）找到绝对的他者和其他人作为力量的源泉。
盆腔手术网片并发症对经历并发症的女性的生活世界产生了广泛的不利影响。如果不将网片并发症视为治疗损伤，就会阻碍更安全替代品的发展，以及行业实践、监管、临床实践和监测的变革，以确保接受创新性尿生殖系统手术的女性的安全。
