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Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review

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Abstract

Introduction and hypothesis

This study describes the incidence, risk factors, and treatments of graft erosion, wound granulation, and dyspareunia as adverse events following vaginal repair of pelvic organ prolapse with non-absorbable synthetic and biologic graft materials.

Methods

A systematic review in Medline of reports published between 1950 and November 2010 on adverse events after vaginal prolapse repairs using graft materials was carried out.

Results

One hundred ten studies reported on erosions with an overall rate, by meta-analysis, of 10.3%, (95% CI, 9.7 – 10.9%; range, 0 – 29.7%; synthetic, 10.3%; biological, 10.1%). Sixteen studies reported on wound granulation for a rate of 7.8%, (95% CI, 6.4 – 9.5%; range, 0 – 19.1%; synthetic, 6.8%; biological, 9.1%). Dyspareunia was described in 70 studies for a rate of 9.1%, (95% CI, 8.2 – 10.0%; range, 0 – 66.7%; synthetic, 8.9%; biological, 9.6%).

Conclusions

Erosions, wound granulation, and dyspareunia may occur after vaginal prolapse repair with graft materials, though rates vary widely across studies.

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Acknowledgments

The following SGS Systematic Review Group members significantly contributed to the acquisition of data: Jeffrey Cornella, MD; Oz Harmanli, MD; Margie A. Kahn, MD; Kimberly Kenton, MD; James Lukban, DO; Michelle Y. Morrill, MD; Abraham N. Morse, MD; Miles Murphy, MD, MSPH; Charles W. Nager, MD; Karl Tammusino, MD; Joseph I. Schaffer, MD; Scott Smilen, MD; Vivian W. Sung, MD, MPH; James P. Theofrastus, MD; Thomas L. Wheeler III, MD, MSPH. Funding of assistance by methods experts in systematic review and logistic support was provided by the Society of Gynecologic Surgeons (SGS).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department Obstetrics & Gynecology, Henry Ford Health System, 3031 West Grand Blvd. 8th Floor, Detroit, MI, 48202, USA

    Husam Abed

  2. University of Texas Southwestern Medical Center, Dallas, TX, USA

    David D. Rahn

  3. Rambam Medical Center, Technion, Haifa, Israel

    Lior Lowenstein

  4. Center for Clinical Evidence Synthesis, Tufts Medical Center, Boston, MA, USA

    Ethan M. Balk

  5. Madigan Army Medical Center, Tacoma, WA, USA

    Jeffrey L. Clemons

  6. University of New Mexico Health Sciences Center, Albuquerque, NM, USA

    Rebecca G. Rogers

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  1. Husam Abed
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  2. David D. Rahn
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  5. Jeffrey L. Clemons
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  6. Rebecca G. Rogers
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For the Systematic Review Group of the Society of Gynecologic Surgeons

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Correspondence to Husam Abed.

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Abed, H., Rahn, D.D., Lowenstein, L. et al. Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Int Urogynecol J 22, 789–798 (2011). https://doi.org/10.1007/s00192-011-1384-5

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  • DOI: https://doi.org/10.1007/s00192-011-1384-5

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