- Mesh procedures for incontinence are associated with a lower risk for complications and subsequent surgery than open colposuspension.
- Mesh procedures for anterior and posterior compartment prolapse are associated with poor outcomes and complications compared with non-mesh repairs.
Why this matters
- Concerns have been raised about the safety of surgery for stress urinary incontinence and pelvic organ prolapse using transvaginal mesh.
- 16,660 (62%) of 26,885 underwent a first, single incontinence procedure.
- Compared with non-mesh open surgery (colposuspension), mesh procedures had:
— lower risk for immediate complications (adjusted relative risk [aRR], 0.44).
— subsequent prolapse surgery (adjusted incidence rate ratio [aIRR], 0.30 for retropubic and 0.26 for transobturator mesh).
— further incontinence surgery admissions (aIRR, 0.90) and later complications (aIRR, 1.12).
- 18,986 (24.5%) of 77,537 women underwent a first, single prolapse procedure.
- Compared with non-mesh repair, mesh repair of anterior compartment prolapse was associated with:
— similar risk for immediate complications (aRR, 0·93).
— an increased risk for further incontinence (aIRR, 3.20), prolapse surgery (aIRR, 1.69) and later complications (aIRR, 3.15).
- Population-based cohort study used a national hospital admission database to extract data for all women (age, ≥20 y) who underwent incontinence and prolapse procedures between 1997 and 2016 in Scotland, UK.
- Funding: None.
- Results restricted to women undergoing first, single incontinence or prolapse procedures.