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Updated: Jan 11, 2026
Transvaginal Mesh Insertion in the Ovine Model
Published on: July 27, 2017
Association of Preoperative Inflammatory and Immune Markers with Mesh Exposure After Transvaginal Mesh Surgery for
Yueyue Yan1, Shuo Liang1, Hua Yang1
1Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Common Mechanism Research for Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Introduction And Hypothesis:
This study was conducted to investigate the associations between baseline absolute monocyte count (AMC), absolute lymphocyte count (ALC), the platelet-to-lymphocyte ratio (PLR), and the risk of mesh exposure following transvaginal mesh (TVM) surgery for pelvic organ prolapse (POP).
Methods:
This prospective cohort study included 206 symptomatic POP patients who underwent TVM treatment with titanium-coated polypropylene mesh (Tiloop) from June 2015 to December 2021 at Peking Union Medical College Hospital. Patients were classified into mesh exposure (n = 23) and non-exposure (n = 183) groups. Baseline hematological indicators, including AMC, ALC, PLR, the neutrophil-to-lymphocyte ratio, the lymphocyte-to-monocyte ratio, and the prognostic nutritional index, were recorded. Restricted cubic spline (RCS) analysis and Cox proportional hazards models were used to assess the associations between these indicators and mesh-exposure risk.
Results:
Mesh exposure occurred in 11.2% of the patients. Significant differences in AMC, ALC, and PLR were detected between the exposure and non-exposure groups. RCS analysis revealed inverse linear associations between AMC and ALC and mesh exposure risk and a positive linear association for the PLR. Lower AMC (adjusted hazard ratio [aHR] = 0.424; 95% CI 0.228-0.786) and ALC (aHR = 0.422; 95% CI 0.255-0.698) were associated with increased mesh exposure risk, whereas higher PLR (aHR = 2.170; 95% CI 1.486-3.169) was associated with increased risk.
Conclusion:
Low AMC and ALC and elevated PLR were independently associated with an increased risk of mesh exposure after TVM surgery.
Insights
Low absolute monocyte count (AMC) and absolute lymphocyte count (ALC), along with a high platelet-to-lymphocyte ratio (PLR), are linked to a greater risk of mesh exposure after transvaginal mesh (TVM) surgery for pelvic organ prolapse (POP).
Area of Science:
- Urogynecology
- Surgical Outcomes
- Inflammatory Markers
Background:
- Transvaginal mesh (TVM) surgery is used for pelvic organ prolapse (POP) but can lead to complications like mesh exposure.
- Identifying predictive factors for mesh exposure is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the association between baseline hematological parameters—absolute monocyte count (AMC), absolute lymphocyte count (ALC), and platelet-to-lymphocyte ratio (PLR)—and the risk of mesh exposure after TVM surgery.
- To determine if these inflammatory markers can serve as predictors for post-TVM mesh complications.
Main Methods:
- A prospective cohort study of 206 patients undergoing TVM surgery for POP.
- Patients were categorized into mesh exposure (n=23) and non-exposure (n=183) groups.
- Baseline AMC, ALC, PLR, and other hematological indices were analyzed using Restricted Cubic Spline and Cox proportional hazards models.
Main Results:
- Mesh exposure occurred in 11.2% of patients.
- Lower AMC and ALC were significantly associated with increased mesh exposure risk (aHR=0.424 and aHR=0.422, respectively).
- A higher PLR was independently associated with an increased risk of mesh exposure (aHR=2.170).
Conclusions:
- Low baseline absolute monocyte count (AMC) and absolute lymphocyte count (ALC) are independent risk factors for mesh exposure following TVM surgery.
- An elevated platelet-to-lymphocyte ratio (PLR) is also associated with a higher risk of mesh exposure.
- These hematological markers may help stratify patients at risk for mesh complications after POP repair.
