Çetin Arslan Hale, Arslan Kadir
Department of Gynecology and Obstetrics, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
Department of Anesthesiology and Reanimation, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
Medicine (Baltimore). 2025 May 9;104(19):e42442. doi: 10.1097/MD.0000000000042442.
Mesh erosions can occur in pelvic reconstructive surgeries for pelvic organ prolapse and stress urinary incontinence. The purpose of this study was to investigate the risk factors and outcomes of mesh erosion after surgical procedures using synthetic mesh. Pelvic reconstructive surgeries performed at a tertiary center during the 5 years between January 2019 and January 2024 were retrospectively analyzed. Patients were classified into the mesh erosion group and the non-erosion group. Clinical features and outcomes were compared. The study included 510 patients, 49 in the mesh erosion group and 461 in the non-erosion group. The incidence of mesh erosion was 9.6%. There was no significant difference between the groups in terms of age, parity, menopausal status, pelvic organ prolapse stage, and concomitant hysterectomy (P = .243, P = .066, P = .349, P = .374, and P = .119, respectively). In the mesh erosion group, body mass index (27.1 ± 3.3 vs 25.9 ± 3.6, P = .016), smoking (28.6% vs 14.3%), sexual activity (77.6% vs 61.8%), vaginal incision size (3.5 ± 1.7 vs 2.3 ± 0.8, P = .001) and hypertension (22.4% vs 13%, P = .070) were significantly higher. Vaginal incision size (>2.5 cm) and sexual activity were found to be independent risk factors for mesh erosion. In patients with mesh erosion, 18.3% (n = 9) received conservative treatment, and 81.7% (n = 40) received surgical treatment. In patients who underwent surgical treatment, mesh erosion size (>0.5 cm) and body mass index were significantly higher (P = .015 and P < .001, respectively). Erosion recurrence was detected in 16.3% (n = 8) of patients in the mesh erosion group. Although mesh erosions do not occur frequently in pelvic reconstructive surgeries, they are complications that can disrupt patient comfort. Vaginal incision size and sexual activity were determined as independent risk factors for mesh erosions. When mesh erosion is detected, conservative treatment may benefit small erosions. The surgical approach should be performed in patients with severe symptoms and extensive erosions.
网片侵蚀可发生在盆腔器官脱垂和压力性尿失禁的盆腔重建手术中。本研究的目的是调查使用合成网片进行手术后网片侵蚀的危险因素和结果。对2019年1月至2024年1月这5年间在一家三级中心进行的盆腔重建手术进行回顾性分析。将患者分为网片侵蚀组和无侵蚀组。比较临床特征和结果。该研究纳入了510例患者，其中网片侵蚀组49例，无侵蚀组461例。网片侵蚀的发生率为9.6%。两组在年龄、产次、绝经状态、盆腔器官脱垂分期和同期子宫切除术方面无显著差异（分别为P = 0.243、P = 0.066、P = 0.349、P = 0.374和P = 0.119）。在网片侵蚀组中，体重指数（27.1±3.3 vs 25.9±3.6，P = 0.016）、吸烟（28.6% vs 14.3%）、性活动（77.6% vs 61.8%）、阴道切口大小（3.5±1.7 vs 2.3±0.8，P = 0.001）和高血压（22.4% vs 13%，P = 0.070）显著更高。阴道切口大小（>2.5 cm）和性活动被发现是网片侵蚀的独立危险因素。在网片侵蚀患者中，18.3%（n = 9）接受了保守治疗，81.7%（n = 40）接受了手术治疗。在接受手术治疗的患者中，网片侵蚀大小（>0.5 cm）和体重指数显著更高（分别为P = 0.015和P < 0.001）。在网片侵蚀组中，16.3%（n = 8）的患者检测到侵蚀复发。虽然网片侵蚀在盆腔重建手术中不常发生，但它们是可能影响患者舒适度的并发症。阴道切口大小和性活动被确定为网片侵蚀的独立危险因素。当检测到网片侵蚀时，保守治疗可能对小侵蚀有益。对于症状严重和侵蚀广泛的患者应采用手术方法。
