The Influence of BMI, Smoking, and Age on Vaginal Erosions After Synthetic Mesh Repair of Pelvic Organ Prolapses. A Multicenter Study

The use of synthetic prostheses for the treatment of stress urinary incontinences and pelvic floor prolapses (POP) has been associated with the occurrence of vaginal erosions, a rather common complication. As with other surgical procedures, after mesh repair of pelvic prolapse, 3 risk factors—body mass index (BMI), smoking, and age—have been associated with the occurrence of postoperative wound infections. It has been proposed that these 3 factors may also influence optimal wound healing and the occurrence of vaginal erosions. This multicenter retrospective study investigated the role of BMI, cigarette smoking, and age on the occurrence of vaginal erosions in 460 patients who had received a mesh-based POP repair between 2002 to 2007 at 3 Italian hospitals. Data were obtained from patient charts and notes. The comparison groups were nonobese women defined as those with BMI 30) patients with postoperative lesions compared to nonobese patients (15% vs. 1.5%, respectively, P 60 years of age compared to those <60 years (10.3% vs. 4.7%, P < 0.05). The risk of vaginal erosions in women who smoke, with a history of <7-pack-years, was not greater than that of nonsmokers, suggesting that light smokers should be placed in a light/nonsmoker category for comparison purposes. The investigators conclude from these findings that identification of BMI, smoking, and age as important risk factors for vaginal erosions after POP surgery, may be useful to stratify patients according to risk and could lead to preventative measures in high-risk patients.