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Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal.
J Urol. 2016 Aug; 196(2):484-9.JU

Abstract

PURPOSE

We reviewed the outcomes of the autologous fascial pubovaginal sling as a salvage procedure for recurrent stress incontinence after intervention for polypropylene mesh erosion/exposure and/or bladder outlet obstruction in patients treated with prior transvaginal synthetic mesh for stress urinary incontinence.

MATERIALS AND METHODS

In a review of surgical databases at 2 institutions between January 2007 and June 2013 we identified 46 patients who underwent autologous fascial pubovaginal sling following removal of transvaginal synthetic mesh in simultaneous or staged fashion. This cohort of patients was evaluated for outcomes, including subjective and objective success, change in quality of life and complications between those who underwent staged vs concomitant synthetic mesh removal with autologous fascial pubovaginal sling placement.

RESULTS

All 46 patients had received at least 1 prior mesh sling for incontinence and 8 (17%) had received prior transvaginal polypropylene mesh for pelvic organ prolapse repair. A total of 30 patients underwent concomitant mesh incision with or without partial excision and autologous sling placement while 16 underwent staged autologous sling placement. Mean followup was 16 months. Of the patients 22% required a mean of 1.8 subsequent interventions an average of 6.5 months after autologous sling placement with no difference in median quality of life at final followup. At last followup 42 of 46 patients (91%) and 35 of 46 (76%) had achieved objective and subjective success, respectively. There was no difference in subjective success between patients treated with a staged vs a concomitant approach (69% vs 80%, p = 0.48).

CONCLUSIONS

Autologous fascial pubovaginal sling placement after synthetic mesh removal can be performed successfully in patients with stress urinary incontinence as a single or staged procedure.

Authors+Show Affiliations

Department of Urology, Medical University of South Carolina, Charleston, South Carolina.Department of Urology, Medical University of South Carolina, Charleston, South Carolina.Department of Urology, Medical University of South Carolina, Charleston, South Carolina.Department of Urology, University of Southern California, Los Angeles, California.Leahy Clinic, Burlington, Massachusetts.Department of Urology, University of Southern California, Los Angeles, California.Department of Urology, Medical University of South Carolina, Charleston, South Carolina. Electronic address: rovnere@musc.edu.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

26997314

Citation

McCoy, Olugbemisola, et al. "Outcomes of Autologous Fascia Pubovaginal Sling for Patients With Transvaginal Mesh Related Complications Requiring Mesh Removal." The Journal of Urology, vol. 196, no. 2, 2016, pp. 484-9.
McCoy O, Vaughan T, Nickles SW, et al. Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal. J Urol. 2016;196(2):484-9.
McCoy, O., Vaughan, T., Nickles, S. W., Ashley, M., MacLachlan, L. S., Ginsberg, D., & Rovner, E. (2016). Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal. The Journal of Urology, 196(2), 484-9. https://doi.org/10.1016/j.juro.2016.02.2976
McCoy O, et al. Outcomes of Autologous Fascia Pubovaginal Sling for Patients With Transvaginal Mesh Related Complications Requiring Mesh Removal. J Urol. 2016;196(2):484-9. PubMed PMID: 26997314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal. AU - McCoy,Olugbemisola, AU - Vaughan,Taylor, AU - Nickles,S Walker, AU - Ashley,Matt, AU - MacLachlan,Lara S, AU - Ginsberg,David, AU - Rovner,Eric, Y1 - 2016/03/17/ PY - 2016/02/25/accepted PY - 2016/3/22/entrez PY - 2016/3/22/pubmed PY - 2018/8/7/medline KW - autografts KW - salvage therapy KW - suburethral slings KW - surgical mesh KW - urinary incontinence SP - 484 EP - 9 JF - The Journal of urology JO - J Urol VL - 196 IS - 2 N2 - PURPOSE: We reviewed the outcomes of the autologous fascial pubovaginal sling as a salvage procedure for recurrent stress incontinence after intervention for polypropylene mesh erosion/exposure and/or bladder outlet obstruction in patients treated with prior transvaginal synthetic mesh for stress urinary incontinence. MATERIALS AND METHODS: In a review of surgical databases at 2 institutions between January 2007 and June 2013 we identified 46 patients who underwent autologous fascial pubovaginal sling following removal of transvaginal synthetic mesh in simultaneous or staged fashion. This cohort of patients was evaluated for outcomes, including subjective and objective success, change in quality of life and complications between those who underwent staged vs concomitant synthetic mesh removal with autologous fascial pubovaginal sling placement. RESULTS: All 46 patients had received at least 1 prior mesh sling for incontinence and 8 (17%) had received prior transvaginal polypropylene mesh for pelvic organ prolapse repair. A total of 30 patients underwent concomitant mesh incision with or without partial excision and autologous sling placement while 16 underwent staged autologous sling placement. Mean followup was 16 months. Of the patients 22% required a mean of 1.8 subsequent interventions an average of 6.5 months after autologous sling placement with no difference in median quality of life at final followup. At last followup 42 of 46 patients (91%) and 35 of 46 (76%) had achieved objective and subjective success, respectively. There was no difference in subjective success between patients treated with a staged vs a concomitant approach (69% vs 80%, p = 0.48). CONCLUSIONS: Autologous fascial pubovaginal sling placement after synthetic mesh removal can be performed successfully in patients with stress urinary incontinence as a single or staged procedure. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/26997314/Outcomes_of_Autologous_Fascia_Pubovaginal_Sling_for_Patients_with_Transvaginal_Mesh_Related_Complications_Requiring_Mesh_Removal_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2016.02.2976?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -