Badri Hawra, Rajai Azita, Ward Karen, Edmondson Richard, Reid Fiona
Warrell Unit, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Manchester Academic Health Science Centre (MAHSC), Manchester, UK.
BMC Womens Health. 2025 Aug 2;25(1):381. doi: 10.1186/s12905-025-03916-8.
To describe the patient cohort accessing a quaternary-level pelvic mesh referral service, identify their requirements and ensure services can meet their needs. To determine areas of future research.
Retrospective and prospective observational study.
Quaternary-level pelvic mesh complications service in the U.K.
Women accessing a pelvic mesh complications service over 5 years.
All women attending the mesh complication service between 2018 and 2023 were included. Data was collected on referral rates, demographics, mesh complications experienced, management options selected, and post operative complications suffered. Mesh complications were compared against mesh devices and management options chosen.
785 women were managed in the mesh service over 5 years. Of 765 women with confirmed mesh devices, 92% (n = 707/765) were referred with a painful mesh complication and 54% (n = 416/765) reported pain alone. 58% requested surgical management (n = 403/692). Of 288 who received surgery, 52% (n = 150/288) requested complete mesh excision. The recurrent Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) rate was 66% (n = 141/215) and 23% (3/13) respectively. 18% (n = 51/288) experienced a surgical complication however only 0.7% (2/288) were considered serious.
This study has identified patients reporting 'pain alone' as the commonest patient cohort attending a UK pelvic mesh centre between 2018 and-2023, suggesting that mesh associated pain exerts considerable burden on affected individuals and maybe more prevalent than once thought. This group has the greatest variation in treatment. Further research is required to understand the pathophysiology of mesh related pain to inform effective treatment options.
描述使用四级盆腔网片转诊服务的患者群体，确定他们的需求并确保服务能够满足其需求。确定未来研究领域。
回顾性和前瞻性观察性研究。
英国的四级盆腔网片并发症服务机构。
5年内使用盆腔网片并发症服务的女性。
纳入2018年至2023年期间所有就诊于网片并发症服务机构的女性。收集转诊率、人口统计学信息、经历的网片并发症、选择的治疗方案以及术后并发症等数据。将网片并发症与所选用的网片装置和治疗方案进行比较。
5年内有785名女性接受了网片服务。在765名确认使用网片装置的女性中，92%（n = 707/765）因疼痛性网片并发症前来转诊，54%（n = 416/765）仅报告有疼痛。58%的患者（n = 403/692）要求手术治疗。在接受手术的288名患者中，52%（n = 150/288）要求完全切除网片。复发性压力性尿失禁（SUI）和盆腔器官脱垂（POP）的发生率分别为66%（n = 141/215）和23%（3/13）。18%（n = 51/288）经历了手术并发症，但只有0.7%（2/288）被认为是严重的。
本研究确定，在2018年至2023年期间，报告“仅疼痛”的患者是英国盆腔网片中心最常见的患者群体，这表明与网片相关的疼痛给受影响个体带来了相当大的负担，可能比之前认为的更为普遍。该群体在治疗方面差异最大。需要进一步研究以了解网片相关疼痛的病理生理学，为有效的治疗方案提供依据。
