New approaches in the study of risk factors and treatment of implant-associated complications in pelvic organ prolapse

Abstract

Aim. To assessment of risk factors for erosion of the vaginal mucosa after the use of mesh prostheses to correct genital prolapse. Materials and methods. The authors of this article evaluated modifiable and unmodifiable risk factors for erosion of the vaginal mucosa after the use of a mesh implant to correct pelvic prolapse. The analysis of the relationship between the indicators of obstetric-gynecological, somatic anamnesis in women with an implant-associated complication (erosion of the vaginal mucosa, n=25) and in women with successful surgical treatment of genital prolapse using a mesh prosthesis (n=58) was carried out. The STATISTICA 10.0 and EViews 12.0 software packages were used for statistical processing of the obtained results. Results. Statistical analysis revealed the relationship of vaginal erosion after the use of a mesh prosthesis in the surgical correction of genital prolapse with the presence of factors such as: premenopausal age at the time of surgery (p=0.002; odds ratio OR 4.7, relative risk RR 2.79), vaginal delivery over the age of 35 years (p=0.003; OR 6.35, RR 2.78), episiotomy in the anamnesis (p0.0001; OR 11.2, RR 6.19), perineal ruptures III degrees in anamnesis (p0.0001; OR 19.7, RR 6.57), hypertension (p=0.049; OR 2.79, RR 2.19), type 2 diabetes mellitus (p=0.007; OR 4.99, RR 1.82). Conclusion. The formation of a high-risk group for erosion of the vaginal mucosa will allow us to develop a set of preventive measures and improve the outcomes of surgical treatment of genital prolapse.

Keywords

• pelvic organ prolapse
• implant-associated complications
• erosion of the vaginal mucosa
• surgery