Risk Factors for Mesh Exposure after Transvaginal Mesh Surgery
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Updated: Mar 17, 2026
Transvaginal Mesh Insertion in the Ovine Model
Published on: July 27, 2017
Ke Niu1, Yong-Xian Lu1, Wen-Jie Shen1
1Department of Gynaecology and Obstetrics, First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China.
Background:
Mesh exposure after surgery continues to be a clinical challenge for urogynecological surgeons. The purpose of this study was to explore the risk factors for polypropylene (PP) mesh exposure after transvaginal mesh (TVM) surgery.
Methods:
This study included 195 patients with advanced pelvic organ prolapse (POP), who underwent TVM from January 2004 to December 2012 at the First Affiliated Hospital of Chinese PLA General Hospital. Clinical data were evaluated including patient's demography, TVM type, concomitant procedures, operation time, blood loss, postoperative morbidity, and mesh exposure. Mesh exposure was identified through postoperative vaginal examination. Statistical analysis was performed to identify risk factors for mesh exposure.
Results:
Two-hundred and nine transvaginal PP meshes were placed, including 194 in the anterior wall and 15 in the posterior wall. Concomitant tension-free vaginal tape was performed in 61 cases. The mean follow-up time was 35.1 ± 23.6 months. PP mesh exposure was identified in 32 cases (16.4%), with 31 in the anterior wall and 1 in the posterior wall. Significant difference was found in operating time and concomitant procedures between exposed and nonexposed groups (F = 7.443, P = 0.007; F = 4.307, P = 0.039, respectively). Binary logistic regression revealed that the number of concomitant procedures and operation time were risk factors for mesh exposure (P = 0.001, P = 0.043).
Conclusion:
Concomitant procedures and increased operating time increase the risk for postoperative mesh exposure in patients undergoing TVM surgery for POP.
Insights
Transvaginal mesh (TVM) surgery for pelvic organ prolapse (POP) carries a risk of mesh exposure. Longer operating times and more concomitant procedures increase this risk, impacting patient outcomes.
Area of Science:
- Urogynecology
- Surgical Innovation
- Pelvic Floor Disorders
Background:
- Mesh exposure following urogynecological surgery remains a significant clinical concern.
- Polypropylene (PP) mesh is frequently used in transvaginal mesh (TVM) procedures for pelvic organ prolapse (POP).
Purpose of the Study:
- To investigate the risk factors associated with polypropylene (PP) mesh exposure after transvaginal mesh (TVM) surgery.
- Identify key variables that contribute to mesh complications in POP repair.
Main Methods:
- A retrospective study of 195 patients with advanced POP undergoing TVM surgery.
- Data collected included patient demographics, mesh type, concomitant procedures, operative time, and postoperative outcomes.
- Statistical analysis, including binary logistic regression, was used to identify risk factors for mesh exposure.
Main Results:
- Polypropylene mesh exposure occurred in 16.4% of cases (32 out of 195 patients).
- Mesh exposure was predominantly observed in the anterior vaginal wall (31 cases).
- Increased operating time and the number of concomitant procedures were significantly associated with higher rates of mesh exposure.
Conclusions:
- Concomitant surgical procedures and prolonged operative duration are identified as significant risk factors for mesh exposure after TVM surgery.
- These findings highlight the importance of surgical technique and patient selection in minimizing mesh-related complications.
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