Long-term follow-up of persistent vaginal polypropylene mesh exposure for transvaginally placed mesh procedures

Introduction and hypothesis

The surgical treatment of a cystocele via the vaginal route may require the placement of a synthetic mesh below the bladder. However, the placement of a synthetic mesh via the vaginal route can be associated with specific complications, such as vaginal mesh exposure. There is a lack of data concerning the long-term follow-up of asymptomatic persistent vaginal polypropylene mesh exposure.

Methods

This was a retrospective case series of nine patients presenting with persistent vaginal mesh exposure following the placement of a macroporous monofilament polypropylene mesh for cystocele treatment. Expectant management has been proposed since the patients were asymptomatic.

Results

The median follow-up duration was 121?months interquartile range (IQR) 119–132]. The median surface area of vaginal mesh exposure (1?cm²; IQR 1–1) did not change significantly during the follow-up. No pelvic or perineal abscess occurred during the follow-up. Only one of them was sexually active; she complained of dyspareunia at the last follow-up, but refused renewed surgery since she had sexual intercourse on only a small number of occasions per year. Clinical examination using the International Continence Society Pelvic Organ Prolapse Quantification system: Ba ?3 to ?2 (n?=?7; 88?%), Ba ?1 (n?=?1; 12?%), Ba 0 or greater (n?=?0).

Conclusions

Persistent asymptomatic vaginal polypropylene mesh exposure is associated with few complications at long-term follow-up.