Risk factors for mesh erosion complicating vaginal reconstructive surgery

Synthetic mesh erosion is a recognised complication for pelvic floor repair surgery which occurs in 1-10% of patients. Our study aimed to evaluate the different risk factors involved in synthetic mesh erosion complicating vaginal reconstructive surgery at a general district hospital. A retrospective audit of 133 vaginal mesh reconstructive operations at Hinchingbrooke Hospital, Cambridgeshire, UK, was carried out. A total of 14 (10.53%) cases of mesh erosion into the vagina were reported. An increased rate of mesh erosion was associated with concurrent vaginal hysterectomy and previous vaginal reconstructive surgery (p < 0.05, RR 3.222, 95% CI 1.071-9.698 and p < 0.05, RR 4.571, 95% CI 1.58-13.23, respectively). The use of Safil (R) suture material (polyglycolic acid) was associated with a higher incidence of Gynecare Gynemesh (R) erosion (p < 0.05, OR = 9, 95% CI 1.073-75.5). It is concluded that this audit has shown the importance of analysing outcomes with all changes of practice, including the change of suture provider.