Are Vaginal Mesh Surgery Concerns Overstated?
(HealthDay News) — Only one out of every 30 women who receive a synthetic vaginal mesh sling to treat stress urinary incontinence will suffer a complication that requires a second surgery, according to a decade-long follow-up study of nearly 60,000 Canadian women. The findings were published online September 9 in JAMA Surgery.
Blayne Welk, MD, an assistant professor of urology at Western University's Schulich School of Medicine & Dentistry in London, Canada, and colleagues tracked the number of Ontario women who needed a follow-up surgery to remove or repair a mesh implant. The study included 59,887 women who underwent the procedure from April 2002 through December 2012.
Overall, 1,307 women – or 2.2% – needed a follow-up surgery within an average of about a year after receiving a mesh implant for stress urinary incontinence, the findings showed. By the end of the decade-long study period, there was a 3.29% cumulative risk of complications, the investigators found. Patients of "low-volume" surgeons were 37% more likely to require a follow-up surgery, when compared to women who received treatment by a surgeon who regularly performs this procedure, the researchers said.
"These findings support the regulatory statements that suggest that patients should be counseled regarding serious complications that can occur with mesh-based procedures for stress urinary incontinence and that surgeons should achieve expertise in their chosen procedure," the authors write. "Multiple mesh-based procedures for stress urinary incontinence are a novel risk factor associated with an almost five-fold higher rate of mesh removal or revision, and the safety of this practice should be studied further."
One author disclosed financial ties to Astellas Canada.