Tobacco use is a risk factor for mesh erosion after abdominal sacral colpoperineopexy

Objective The purpose of this study was to evaluate the association between smoking and vaginal mesh erosion after abdominal sacral colpoperineopexy with the use of type 1 polypropylene mesh. Study Design All cases of mesh erosion (n = 27) that were diagnosed between October 2003 and June 2006 were...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2008-05, Vol.198 (5), p.561.e1-561.e4
Main Authors: Lowman, Joye K., MD, MPH, Woodman, Patrick J., DO, Nosti, Patrick A., MD, Bump, Richard C., MD, Terry, Colin L., MS, Hale, Douglass S., MD
Format: Article
Language:English
Subjects:
abdominal sacral colpoperineopexy
abdominal sacral colpopexy
Aged
Biological and medical sciences
Case-Control Studies
Confounding Factors (Epidemiology)
Equipment Failure
Female
Gynecologic Surgical Procedures
Gynecology. Andrology. Obstetrics
Humans
Ligaments - surgery
Medical sciences
mesh erosion
Middle Aged
Obstetrics and Gynecology
Odds Ratio
polypropylene mesh
Postoperative Complications - epidemiology
Prostheses and Implants - adverse effects
Risk Factors
smoking
Smoking - adverse effects
Surgical Mesh - adverse effects
Suture Techniques
Tobacco, tobacco smoking
Toxicology
Uterine Prolapse - surgery
Vagina - surgery
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Summary:Objective The purpose of this study was to evaluate the association between smoking and vaginal mesh erosion after abdominal sacral colpoperineopexy with the use of type 1 polypropylene mesh. Study Design All cases of mesh erosion (n = 27) that were diagnosed between October 2003 and June 2006 were identified and compared with matched control cases (n = 81). Control cases were matched for age, diabetes mellitus status, hypoestrogenic state (menopausal status, chronic steroid use, use of hormone therapy), abdominal-vaginal rectocele repair, culdoplasty, and concomitant hysterectomy. Demographic data, surgical characteristics, and postoperative complications were also compared between groups. Continuous data were compared using 2-sample Student t tests. Categoric data were compared with the use of Pearson Chi-square tests. Results The odds of experiencing mesh erosion was significantly greater in smokers than in nonsmokers (odds ratio, 4.4; 95% CI, 1.3, 14.4; P = .010) when potential confounders were similar between groups. Conclusion Tobacco use is a risk factor for vaginal mesh erosion after abdominal sacral colpoperineopexy with the use of type 1 polypropylene mesh.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2008.01.048