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International Urogynecology Journal

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01-08-2013 | Original Article

Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse

Authors: Michele Jonsson Funk, Anthony G. Visco, Alison C. Weidner, Virginia Pate, Jennifer M. Wu

Published in: International Urogynecology Journal | Issue 8/2013

Abstract

Introduction and hypothesis

To estimate the risk of repeat surgery for recurrent prolapse or mesh removal after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.

Methods

We utilized longitudinal, adjudicated, healthcare claims from 2005 to 2010 to identify women ≥18 years who underwent an anterior colporrhaphy (CPT 57420) with or without concurrent vaginal mesh (CPT 57267). The primary outcome was repeat surgery for anterior or apical prolapse or for mesh removal/revision; these outcomes were also analyzed separately. We utilized Kaplan–Meier curves to estimate the cumulative risk of each outcome after vaginal mesh versus native tissue repair. Cox proportional hazards models were used to estimate the hazard ratio (HR) for vaginal mesh versus native tissue repair, adjusted for age, concurrent hysterectomy, and concurrent or recent sling.

Results

We identified 27,809 anterior prolapse surgeries with 49,658 person-years of follow-up. Of those, 6,871 (24.7%) included vaginal mesh. The 5-year cumulative risk of any repeat surgery was significantly higher for vaginal mesh versus native tissue (15.2 % vs 9.8 %, p <0.0001) with a 5-year risk of mesh revision/removal of 5.9%. The 5-year risk of surgery for recurrent prolapse was similar between vaginal mesh and native tissue groups (10.4 % vs 9.3 %, p = 0.70. The results of the adjusted Cox model were similar (HR 0.93, 95%CI: 0.83, 1.05).

Conclusions

The use of mesh for anterior prolapse was associated with an increased risk of any repeat surgery, which was driven by surgery for mesh removal. Native tissue and vaginal mesh surgery had similar 5-year risks for surgery for recurrent prolapse.

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Title: Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse
Authors: Michele Jonsson Funk
Anthony G. Visco
Alison C. Weidner
Virginia Pate
Jennifer M. Wu
Publication date: 01-08-2013
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 8/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2043-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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