Mesh–related and intraoperative complications of pelvic organ prolapse repair

INTRODUCTION: To evaluate the rates of complications of pelvic organ prolapse repair and to determine their risk factors. MATERIAL AND METHODS: The study included 677 patients operated for pelvic organ prolapse with trocar guided Prolift mesh. Patients were followed up within 1 and 3 months. A phone interview was conducted and patients with complaints were invited and evaluated in office settings. RESULTS: Mean age was 60 years. For the phone interview, 86.5% of patients were available. Overall complication rates were 22.5% (152/677). Fifteen patients (2.2%) developed bleeding over 500 cc; pelvic hematomas – 5.5%; perineal hematomas – 2.5%; urethral injuries – 0.3%; bladder injury in 1.6%; rectal damage in 0.7% and ureteral trauma in 0.2%. Mesh related complications included: erosions in 4.8%; vaginal synechiae – 0.3%; protrusion of mesh into the bladder – 0.15%; vesicovaginal fistula with mesh protrusion – 0.3%; mesh shrinkage – 1%; dyspareunia and pain in 2.4% cases. Pelvic abscess was found in 0.6% including one case of lethal necrotizing fasciitis. The risk factors of complications were assessed via logistic regression analysis. CONCLUSIONS: Younger age, less prominent prolapse, hematomas and concomitant hysterectomies are associated with higher risk of complications.