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Tytuł:
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Mesh-related complications from reconstructive surgery for pelvic organ prolapse in Chinese patients in Hong Kong.
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Autorzy:
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Wan OY; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Chan SS; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Cheung RY; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Chung TK; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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Źródło:
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Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2018 Aug; Vol. 24 (4), pp. 369-377. Date of Electronic Publication: 2018 Jul 31.
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Typ publikacji:
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Journal Article; Observational Study
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Język:
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English
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Imprint Name(s):
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Publication: Hong Kong : Hong Kong Academy of Medicine Press
Original Publication: Hong Kong : Churchill Livingstone, c1995-
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MeSH Terms:
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Pelvic Organ Prolapse/*surgery
Postoperative Complications/*epidemiology
Plastic Surgery Procedures/*adverse effects
Reoperation/*statistics & numerical data
Surgical Mesh/*adverse effects
Aged ; Female ; Hong Kong/epidemiology ; Humans ; Logistic Models ; Middle Aged ; Prospective Studies
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Contributed Indexing:
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Keywords: Pelvic organ prolapse/surgery; Postoperative complications; Surgical mesh/adverse effects
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Entry Date(s):
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Date Created: 20180802 Date Completed: 20181211 Latest Revision: 20221207
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Update Code:
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20240104
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DOI:
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10.12809/hkmj177173
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PMID:
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30065122
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Introduction: Mesh-related complications from reconstructive surgery for pelvic organ prolapse are of international concern. The present study aimed to review the incidence, management, and surgical outcomes of mesh-related complications in a Chinese population compared with existing studies involving Western populations.
Methods: This was an analysis of a prospectively collected cohort. Laparoscopic sacrocolpopexy, laparoscopic hystercolposacropexy, or transvaginal mesh surgery were offered with or without concomitant vaginal hysterectomy or continence surgery. Patients were followed up and mesh-related complications were noted.
Results: Overall, 276 Chinese women who received mesh surgery were included for data analysis. There were 22 mesh-related complications found during a mean follow-up period of 40 months. Mesh exposure accounted for 20 these complications; significantly more occurred after transvaginal than after abdominal mesh surgery (16 vs 4; P=0.01). Median duration from primary operation to the time of mesh exposure detection was 12 months (interquartile range=4.8-32.8 months). Ten patients required surgical excisions of exposed mesh. The re-operation rate after mesh complications was 6.7% (9/134) for transvaginal mesh surgery and 1.4% (2/142) for laparoscopic sacrocolpopexy (P=0.03). All excisions were performed transvaginally and 95% remained well after surgery. Occurrence of mesh exposure was higher in transvaginal mesh surgery (adjusted odds ratio=6.1; P=0.008), in sexually active patients (adjusted odds ratio=5.4; P=0.002), and in obese patients (adjusted odds ratio=3.7; P=0.046). Over 90% were satisfied with the outcome, regardless of mesh complications.
Conclusions: The rates of mesh exposure and re-operation were consistent with those reported in the literature, suggesting no significant differences in outcome between Chinese and Western patients for this type of surgery.