Clinical predictors and risk factors for vaginal mesh extrusion.

Usah Khrucharoen, Patkawat Ramart, Judy Choi, Diana Kang, Ja-Hong Kim, Shlomo Raz

Abstract read

In one paragraph

Article in World journal of urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it

0cells of the map it votes in

4citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

Dysregulated wound healing in the pathogenesis of urogynecologic mesh complications.Scientific reports · 2023
Article
Predictors of Clinical Outcome in Women with Pelvic Organ Prolapse Who Underwent Transvaginal Mesh Reconstruction Surgery.Medicina (Kaunas, Lithuania) · 2022
Article
Comparison of the efficiency of partial versus subtotal mesh removal on urogenital distress and sexual functions after stress urinary incontinence surgery.Turkish journal of urology · 2020
Article
Wound dehiscence prevalence and relationship with prosthetic material extrusion in women underwent anterior colpotomy.Therapeutic advances in urology
Article

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Usah KhrucharoenDavid Geffen School of Medicine, University of California, Los Angeles Medical Center, 11301 Wilshire Blvd. Bldg. 115, Rm. 320, Los Angeles, CA, 90073, USA. UKhrucharoen@mednet.ucla.edu.ORCID http://orcid.org/0000-0002-3585-5063

Patkawat RamartDivision of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Los Angeles, CA, USA.

Judy ChoiDivision of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Los Angeles, CA, USA.

Diana KangDivision of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Los Angeles, CA, USA.

Ja-Hong KimDivision of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Los Angeles, CA, USA.

Shlomo RazDivision of Pelvic Medicine and Reconstructive Surgery, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposesOur study aims to enhance the accuracy of the clinical diagnosis in patients with vaginal mesh extrusion following transvaginal mesh placement for pelvic organ prolapse using significant clinical parameters and risk factors.

methodsAll patients who underwent vaginal mesh removal were retrospectively reviewed from January 2000 to May 2014. Eligible patients were divided into two groups according to the presence of vaginal mesh extrusion.

resultsA total of 862 patients, 798 were included. 357 (44.7%) had evidence of vaginal mesh extrusion, and 441 (55.3%) had no evidence of vaginal mesh extrusion. The mean age of the vaginal mesh extrusion group was slightly higher than in the group without vaginal mesh extrusion (58.7 ± 11.2 vs. 56.4 ± 11.5, respectively; p = 0.002). From multivariate analysis, the significant clinical correlations for vaginal mesh extrusion were vaginal bleeding [60 (16.9) vs. 14 (3.2%), p < 0.001], hispareunia [48 (13.5) vs. 15 (3.4%), OR = 4.163, p < 0.001], and vaginal discharge [45 (12.6) vs. 18 (4.1%), p = 0.001]. The risk factors were multiple mesh implantations [218 (67.06) vs. 175 (39.68%), p < 0.001] and menopause [314 (88) vs. 364 (82.7%), p = 0.145]. Demographic data, including BMI, sexual activity, vaginal atrophy, both local and systemic hormonal use, smoking status, and hysterectomy status, were not significantly different, as well as the clinical symptoms including dyspareunia, vaginal infection, and symptomatic vaginal bulge.

conclusionsVaginal bleeding, hispareunia, and vaginal discharge were the most significant clinical predictors for raising suspicion of vaginal mesh extrusion. Multiple mesh implantations were a significant risk factor for extrusion.

Indexed as

Surgical MeshAdultAgedDevice RemovalFemaleForeign-Body MigrationHumansMenopauseMiddle AgedMultivariate AnalysisPelvic Organ ProlapsePostoperative ComplicationsReoperationRetrospective StudiesRisk FactorsUterine HemorrhageClinical predictorsMesh extrusionRisk factorsTransvaginal meshVaginal symptoms

Identifiers

PMID29170793

DOI10.1007/s00345-017-2137-y

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.