{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T00:38:38Z","timestamp":1794271118776,"version":"4.9.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010377","name":"National Institute for Health and Care Excellence","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Mesh surgery for stress urinary incontinence or pelvic organ prolapse can result in complications such as mesh exposure, mesh extrusion, voiding dysfunction, dyspareunia, and pain. There is limited knowledge or guidance on the effective management for mesh\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the best management of mesh complications; a systematic review was conducted as part of the national clinical guideline \u2018Urinary incontinence (update) and pelvic organ prolapse in women: management\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>Search strategies were developed for each indication for referral.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Relevant interventions included complete or partial mesh removal, mesh division, and non\u2010surgical treatments such as vaginal estrogen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Characteristics and outcome data were extracted, and as a result of the heterogeneous nature of the data a narrative synthesis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Twenty\u2010four studies were included; five provided comparative data and four studies stated the indication for referral. Reported outcomes (including pain, dyspareunia, satisfaction, quality of life, incontinence, mesh exposure, and recurrence) and the reported incidences of these varied widely.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The current evidence base is limited in quantity and quality and does not permit firm recommendations to be made on the most effective management for mesh\u2010related complications. Robust data are needed so that mesh complications can be managed effectively in the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Systematic review demonstrates that the outcomes following mesh revision surgery are highly variable.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15958","type":"journal-article","created":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T16:18:50Z","timestamp":1569082730000},"page":"28-35","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Management of mesh complications following surgery for stress urinary incontinence or pelvic organ prolapse: a systematic review"],"prefix":"10.1111","volume":"127","author":[{"given":"P","family":"Carter","sequence":"first","affiliation":[{"name":"Research Department of Clinical Educational &amp; Health Psychology University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Fou","sequence":"additional","affiliation":[{"name":"National Guideline Alliance Royal College of Obstetricians and Gynaecologists London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Whiter","sequence":"additional","affiliation":[{"name":"National Guideline Alliance Royal College of Obstetricians and Gynaecologists London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Delgado Nunes","sequence":"additional","affiliation":[{"name":"National Guideline Alliance Royal College of Obstetricians and Gynaecologists London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Hasler","sequence":"additional","affiliation":[{"name":"National Guideline Alliance Royal College of Obstetricians and Gynaecologists London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Austin","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Excellence Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Macbeth","sequence":"additional","affiliation":[{"name":"Centre for Trials Research Cardiff University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Ward","sequence":"additional","affiliation":[{"name":"The Warrell Unit St Mary's Hospital Manchester UK"},{"name":"Manchester Academic Health Science Centre University Hospitals NHS Foundation Trust Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Kearney","sequence":"additional","affiliation":[{"name":"The Warrell Unit St Mary's Hospital Manchester UK"},{"name":"Manchester Academic Health Science Centre University Hospitals NHS Foundation Trust Manchester UK"},{"name":"Faculty of Medical Human Sciences University Institute of Human Development University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4137"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7355.67"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.03.030"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318203e6a5"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-011-1384-5"},{"key":"e_1_2_6_7_1","unstructured":"Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR).Opinion on The safety of surgical meshes used in urogynecological surgery. 2015 [cited 2019 18th March]; 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