Analysis and managment of complications of pelvic floor reconstructive surgery with graft

Objective To investigate the complications of pelvic floor reconstructive surgery with graft and the managment of them. Methods A total of 176 patients with moderate to severe pelvic organ prolapse (POP) who underwent pelvic floor reconstructive surgery with graft at the Obstetrics and Gynecology Department of Peking University First Hospital from February 2006 to July 2009 were recruited in this study.The complications and treatments were analysed.Results ① There had no intraoperative complications occurred.② The incidence of short term postoperative complications was 2.27% (4/176),including 1 case of urinary tract infection (0.57%),1 case of hematoma in the right thigh deep beneath hip (0.57%) and 2 cases of fecal incontinence (1.14%).③ 151 cases of the 176 patients were under followe-up.Incidence of long-term complications after surgery was 35.76% (54/151).38 mesh erosion occurred (25.17%) in which 4 cases had re-erosion. There were two cases of vaginal lancinating (1.32%),three cases of thigh pain or discomfort (1.99%),one with vaginal adhesion (0.66%),three with urethral pain (1.99%),four with falling and inflation sense of anus (2.65%),two with difficult defecation(1.32%)and one with perineum pain (0.66%).④ Postoperative mesh erosion was not related with menopause,diabetes,operative time,blood loss and postoperative maximum body temperature (P0.05),but it was age-related (r=0.921,P=0.012). The high incident ages of erosion were 47~55 years and older than 63 years. Conclusion The pelvic floor reconstructive surgery with graft may bring some postoperative complications to patients. Surgical options should be carefully considered.