Mesh Exposure and Associated Risk Factors in Women Undergoing Transvaginal Prolapse Repair with Mesh

Objective. To determine frequency, rate, and risk factors associated with mesh exposure in women undergoing transvaginal prolapse repair with polypropylene mesh. Methods. Retrospective chart review was performed for all women who underwent Prolift Pelvic Floor Repair System (Gynecare, Somerville, NJ) between September 2005 and September 2008. Multivariable logistic regression was performed to identify risk factors for mesh exposure. Results. 201 women underwent Prolift. Mesh exposure occurred in 12% (24/201). Median time to mesh exposure was 62 days (range: 10-372). When mesh was placed in the anterior compartment, the frequency of mesh exposure was higher than that when mesh was placed in the posterior compartment (8.7% versus 2.9%,P = 0.04). Independent risk factors for mesh exposure were diabetes (AOR = 7.7, 95% CI 1.6-37.6; P = 0.01) and surgeon (AOR=7.3, 95% CI 1.9-28.6; P = 0.004). Conclusion. Women with diabetes have a 7-fold increased risk for mesh exposure after transvaginal prolapse repair using Prolift. The variable rate of mesh exposure amongst surgeons may be related to technique. The anterior vaginal wall may be at higher risk of mesh exposure as compared to the posterior vaginal wall.