• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Results from the French VIGI-MESH registry: Short-Term Complications Following Pelvic Floor Surgery

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • The VIGI-MESH registry was established to assess complications arising from stress urinary incontinence (SUI) or pelvic organ prolapse (POP) surgeries beyond RCTs
  • Using VIGI-MESH data, Fritel et al. (BJOG, 2019) analyzed the short-term incidence of serious complications arising from SUI or POP surgeries

METHODS:

  • Prospective longitudinal cohort study (between February 2017 and August 2018)
  • Setting
    • Thirteen public hospitals in France
  • Participants
    • Women undergoing SUI or POP surgical repair
  • Study design
    • Surgeons reported procedures and complications
    • Verified by the hospitals information systems
  • Primary outcomes
    • Serious complication: (1) Requiring discontinuation of the procedure or (2) subsequent surgical intervention
    • Life-threatening complication requiring resuscitation
    • Death

RESULTS:

  • 1,873 women were included
    • Serious complication rate: 2.8%
    • Need for resuscitation: 1 patient
    • No deaths reported
    • Mean follow-up of 7 months (0-18 months)
  • Removal of mesh
    • Midurethral slings (MUSs): 1.4% (11/811); 95% CI, 0.7 to 2.3%
    • Transvaginal meshes: 0.5% (2/391); 95% CI, 0.1 to 1.6%
    • Laparoscopically placed mesh implants: 0.7% (4/611); 95% CI, 0.2 to 1.5%
  • Estimated incidence of serious complications 6 months after the surgical procedure
    • MUS alone: 3.5% (95% CI, 2.0 to 5.0%)
    • MUS with prolapse surgery: 7.0% (95% CI, 2.8 to 11.3%) 
    • Vaginal native tissue repair: 1.7% (95% CI, 0.0 to 3.8%)
    • Transvaginal mesh: 2.8% (95% CI, 0.9 to 4.6%) 
    • Laparoscopy with mesh: 1.0% (95% CI, 0.1 to 1.9%)
  • Several MUS complications were related to sling adjustments (loosening or division)   
  • Most complications were related to intraoperative bladder injuries during vaginal surgery resulting in discontinuation of the mesh or sling placement
  • Early complications: Bladder voiding after MUS accounted for 50% of early complications
  • Later complications: Vaginal exposure of either MUS or mesh
    • More often when placed vaginally vs via laparoscope

CONCLUSION:

  • SUI or POP surgery complications are rare
  • While an additional surgical procedure will be classified as a complication, the authors note that one of the benefits of MUS for SUI is the ability to adjust the sling, which is not possible with other procedures (e.g., retropubic colposuspension or traditional sling)
  • Monitoring surgical outcomes including use of mesh and other materials is of value | Long-term follow up is necessary

Learn More – Primary Sources:

Complications after pelvic floor repair surgery (with and without mesh): short‐term incidence after 1873 inclusions in the French VIGI‐MESH registry

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

Learn More  »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

ACOG/AUGS Guidance Update: Diagnosis and Management of Pelvic Organ Prolapse Including Role of Mesh
Prolapse and Stress Incontinence: Burch Procedure vs Midurethral Sling
Surgery for Stress Urinary Incontinence: Which Procedures are Most Effective and Safest?
Midurethral Tape and Repeat Surgery for Stress Incontinence: Is the 2nd Time the Charm?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site