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Histopathology of excised midurethral sling mesh.

Publication ,  Journal Article
Hill, AJ; Unger, CA; Solomon, ER; Brainard, JA; Barber, MD
Published in: Int Urogynecol J
April 2015

INTRODUCTION AND HYPOTHESIS: The objective of this study was to compare the histological characteristics of pathological specimens of excised midurethral sling mesh and surrounding vaginal tissue in patients who presented preoperatively with pain and/or exposure of mesh to patients who underwent mesh excision for voiding dysfunction without pain and/or erosion. METHODS: This is a retrospective case-control study of women who underwent excision of midurethral sling mesh between 2008 and 2013. Three groups were identified: (1) voiding dysfunction without pain or exposure (control group), (2) pain and/or mesh exposure, and (3) voiding dysfunction with pain and/or mesh exposure. All original pathological specimens were rereviewed by one pathologist blinded to indication for excision and the previous pathology report. Degree of inflammation and fibrosis were recorded based on a 4-point scale along with the presence of giant cell reaction. RESULTS: A total of 130 subjects met inclusion criteria: 60 (46.2 %) with voiding dysfunction only, 21 (16.2 %) with pain/erosion, and 49 (37.7 %) with both pain/exposure and voiding dysfunction. The voiding dysfunction only group was found to have significantly higher levels of inflammation, median grade 2 (1-3), compared to the other two groups with a p value of 0.007. There were no statistical differences in fibrosis and giant cell reaction between the three groups. CONCLUSIONS: Midurethral sling mesh excised for voiding dysfunction demonstrates elevated levels of inflammation compared to mesh that is excised for pain and/or exposure. The vaginal tissue fibrosis and giant cell reaction are similar in patients who undergo mesh excision for voiding dysfunction and pain, and/or mesh exposure.

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Published In

Int Urogynecol J

DOI

EISSN

1433-3023

Publication Date

April 2015

Volume

26

Issue

4

Start / End Page

591 / 595

Location

England

Related Subject Headings

  • Vagina
  • Urination Disorders
  • Surgical Mesh
  • Suburethral Slings
  • Retrospective Studies
  • Pain
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Inflammation
  • Humans
 

Citation

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Hill, A. J., Unger, C. A., Solomon, E. R., Brainard, J. A., & Barber, M. D. (2015). Histopathology of excised midurethral sling mesh. Int Urogynecol J, 26(4), 591–595. https://doi.org/10.1007/s00192-014-2553-0
Hill, Audra Jolyn, Cecile A. Unger, Ellen R. Solomon, Jennifer A. Brainard, and Matthew D. Barber. “Histopathology of excised midurethral sling mesh.Int Urogynecol J 26, no. 4 (April 2015): 591–95. https://doi.org/10.1007/s00192-014-2553-0.
Hill AJ, Unger CA, Solomon ER, Brainard JA, Barber MD. Histopathology of excised midurethral sling mesh. Int Urogynecol J. 2015 Apr;26(4):591–5.
Hill, Audra Jolyn, et al. “Histopathology of excised midurethral sling mesh.Int Urogynecol J, vol. 26, no. 4, Apr. 2015, pp. 591–95. Pubmed, doi:10.1007/s00192-014-2553-0.
Hill AJ, Unger CA, Solomon ER, Brainard JA, Barber MD. Histopathology of excised midurethral sling mesh. Int Urogynecol J. 2015 Apr;26(4):591–595.
Journal cover image

Published In

Int Urogynecol J

DOI

EISSN

1433-3023

Publication Date

April 2015

Volume

26

Issue

4

Start / End Page

591 / 595

Location

England

Related Subject Headings

  • Vagina
  • Urination Disorders
  • Surgical Mesh
  • Suburethral Slings
  • Retrospective Studies
  • Pain
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Inflammation
  • Humans