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Bleeding Complications Up With Multicompartment Mesh Removal

Increased estimated blood loss and elevated odds of transfusion with multicompartment removal

WEDNESDAY, May 20, 2015 (HealthDay News) -- For women undergoing vaginal mesh removal, bleeding complications are higher for removal from multiple vaginal compartments versus a single vaginal compartment, according to research published May 6 in Obstetrics & Gynecology.

Stephanie D. Pickett, M.D., from the University of Oklahoma Health Sciences Center in Oklahoma City, and colleagues conducted a retrospective review to examine perioperative complications of mesh removal performed in the operating room. The authors compared the morbidity associated with single-compartment mesh removal (326 patients) versus removal from multiple vaginal compartments (48 patients) during a 75-month period.

The researchers found that pain, dyspareunia, mesh exposure, and voiding dysfunction were indications for mesh removal (63, 57, 54, and 39 percent, respectively). Mesh removed had a mean length of 4 cm. Estimated blood loss was approximately three times higher for multicompartment surgery versus single-compartment surgery (P < 0.001). Compared with single-compartment surgery, the odds of transfusion were more than nine times higher after multicompartment surgery (odds ratio, 9.7; P < 0.01).

"When removing mesh materials, multiple-compartment surgery carries a greater risk of a bleeding morbidity compared to single-compartment surgery," the authors write. "This information will supplement the knowledge of the consulting surgeon as to the best way to manage and plan mesh removal surgery."

One author disclosed financial ties to the medical device and biotechnology industries.

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