{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:19:28Z","timestamp":1772165968542,"version":"3.50.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shenyang Science and Technology Plan Project","award":["18-014-4-29"],"award-info":[{"award-number":["18-014-4-29"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The purpose of this study was to investigate the relevant factors of pain after transvaginal mesh (TVM) surgery for the treatment of pelvic organ prolapse and to analyse the management and relief of the pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicentre retrospective study of a clinical database of patients who underwent TVM surgery was conducted, and pain related aspects were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1855 patients were included in the study. We divided the patients into two groups: pain-free (1805 patients) and pain (50 patients) group. The incidence of pain after TVM surgery was 2.70%, with a median occurrence time of 7.5\u00a0months. Pain mainly involved the vagina, perineum, buttocks, groin, inner thighs, and lower abdomen. Excessive intraoperative blood loss (OR\u2009=\u20091.284, 95% CI 0.868\u20132.401) and postoperative anatomic failure (OR\u2009=\u20091.577, 95% CI 0.952\u20133.104) were analysed as risk factors with statistical significance. Mesh exposure rate in the pain group was 38%, showing a significant difference between the groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Forty patients underwent non-surgical treatment, with a relief rate of 40.0%, 33 patients received surgical treatment, 15 underwent partial mesh removal, and 18 underwent complete mesh removal, with a relief rate of 84.8%. The total relief rate was 88% within all 50 patients suffering from pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Excessive intraoperative bleeding and unsatisfactory postoperative anatomic outcomes can increase the risk of postoperative pain; mesh exposure is also associated with the pain. Most patients can get pain relief with proper management, more than half of whom may need mesh removal with differing approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12905-021-01192-w","type":"journal-article","created":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T08:02:52Z","timestamp":1611993772000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical analysis of pain after transvaginal mesh surgery in patients with pelvic organ prolapse"],"prefix":"10.1186","volume":"21","author":[{"given":"Chang","family":"Shi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runqi","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yitong","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4628-569X","authenticated-orcid":false,"given":"Zhijun","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,30]]},"reference":[{"issue":"6","key":"1192_CR1","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1067\/mob.2002.123819","volume":"186","author":"SL Hendrix","year":"2002","unstructured":"Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the Women\u2019s Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160\u20136.","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"1192_CR2","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.ajog.2003.07.017","volume":"190","author":"VL Handa","year":"2004","unstructured":"Handa VL, Garrett E, Hendrix S, Gold E, Robbins J. Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women. Am J Obstet Gynecol. 2004;190(1):27\u201332.","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"1192_CR3","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1001\/jama.300.11.1311","volume":"300","author":"I Nygaard","year":"2008","unstructured":"Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA J Am Med Assoc. 2008;300(11):1311\u20136.","journal-title":"JAMA J Am Med Assoc"},{"issue":"9","key":"1192_CR4","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s00192-009-0902-1","volume":"20","author":"MCP Slieker-ten Hove","year":"2009","unstructured":"Slieker-ten Hove MCP, Pool-Goudzwaard AL, Eijkemans MJC, Steegers-Theunissen RPM, Burger CW, Vierhout ME. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. Int Urogynecol J. 2009;20(9):1037\u201345.","journal-title":"Int Urogynecol J"},{"issue":"4","key":"1192_CR5","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/S0029-7844(97)00058-6","volume":"89","author":"AL Olsen","year":"1997","unstructured":"Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501\u20136.","journal-title":"Obstet Gynecol"},{"issue":"6","key":"1192_CR6","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1097\/AOG.0000000000000286","volume":"123","author":"JM Wu","year":"2014","unstructured":"Wu JM, Matthews CA, Conover MM, Pate V, Funk MJ. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201\u20136.","journal-title":"Obstet Gynecol"},{"issue":"11","key":"1192_CR7","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1007\/s00192-013-2169-9","volume":"24","author":"MD Barber","year":"2013","unstructured":"Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24(11):1783\u201390.","journal-title":"Int Urogynecol J"},{"issue":"2","key":"1192_CR8","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1097\/AOG.0b013e318195888d","volume":"113","author":"GB Diwadkar","year":"2009","unstructured":"Diwadkar GB, Barber MD, Feiner B, Maher C, Jelovsek JE. Complication and reoperation rates after apical vaginal prolapse surgical repair a systematic review. Obstet Gynecol. 2009;113(2):367\u201373.","journal-title":"Obstet Gynecol"},{"issue":"2","key":"1192_CR9","first-page":"Cd 012079","volume":"2","author":"C Maher","year":"2016","unstructured":"Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Marjoribanks J. Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse. Cochrane Database Syst Rev. 2016;2(2):Cd 012079.","journal-title":"Cochrane Database Syst Rev"},{"key":"1192_CR10","unstructured":"US Food and Drug Administration. FDA public health notification: serious complications associated with transvaginal placement of surgical mesh in repair of pelvic organ prolapse and stress urinary incontinence. FDA.gov. 2008. http:\/\/www.fda.gov\/MedicalDevices\/Safety\/AlertsandNotices\/PublicHealthNotifications\/ucm061976.htm. Accessed 17 Apr 2016."},{"issue":"5","key":"1192_CR11","doi-asserted-by":"publisher","first-page":"1674","DOI":"10.1016\/j.juro.2011.12.066","volume":"187","author":"F Firoozi","year":"2012","unstructured":"Firoozi F, Ingber MS, Moore CK, Vasavada SP, Rackley RR, Goldman HB. Purely transvaginal\/perineal management of complications from commercial prolapse kits using new prostheses\/grafts complication classification system. J Urol. 2012;187(5):1674\u20139.","journal-title":"J Urol"},{"issue":"5","key":"1192_CR12","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/j.1471-0528.2008.02023.x","volume":"116","author":"B Feiner","year":"2009","unstructured":"Feiner B, Jelovsek JE, Maher C. Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic review. Br J Obstet Gynaecol. 2009;116(5):15\u201324.","journal-title":"Br J Obstet Gynaecol"},{"issue":"11","key":"1192_CR13","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1007\/s00192-011-1476-2","volume":"22","author":"MM Tijdink","year":"2011","unstructured":"Tijdink MM, Vierhout ME, Heesakkers JP, Withagen MIJ. Surgical management of mesh-related complications after prior pelvic floor reconstructive surgery with mesh. Int Urogynecol J. 2011;22(11):1395\u2013404.","journal-title":"Int Urogynecol J"},{"issue":"1","key":"1192_CR14","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.jmig.2016.10.001","volume":"24","author":"EJ Geller","year":"2007","unstructured":"Geller EJ, Babb E, Nackley AG, Zolnoun D. Incidence and risk factors for pelvic pain following mesh implant surgery for the treatment of pelvic floor disorders. J Minim Invas Gyn. 2007;24(1):67\u201373.","journal-title":"J Minim Invas Gyn"},{"issue":"3","key":"1192_CR15","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1097\/AOG.0b013e3182479283","volume":"119","author":"JN Nguyen","year":"2012","unstructured":"Nguyen JN, Jakus-Waldman SM, Walter AJ, White T, Menefee SA. Perioperative complications and reoperations after incontinence and prolapse surgeries using prosthetic implants. Obstet Gynecol. 2012;119(3):539\u201346.","journal-title":"Obstet Gynecol"},{"issue":"24","key":"1192_CR16","first-page":"217","volume":"24","author":"D Barski","year":"2014","unstructured":"Barski D, Otto T, Gerullis H. Systematic review and classification of complications after anterior, posterior, apical, and total vaginal mesh implantation for prolapse repair. Surg Tech Int. 2014;24(24):217\u201324.","journal-title":"Surg Tech Int"},{"issue":"3","key":"1192_CR17","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1007\/s00192-013-2256-y","volume":"25","author":"AN Gyang","year":"2014","unstructured":"Gyang AN, Feranec JB, Patel RC, Lamvu GM. Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh. Int Urogynecol J. 2014;25(3):313\u20138.","journal-title":"Int Urogynecol J"},{"issue":"1","key":"1192_CR18","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1097\/AOG.0000000000000042","volume":"123","author":"EC Crosby","year":"2014","unstructured":"Crosby EC, Abernethy M, Berger MB, DeLancey JO, Fenner DE, Morgan DM. Symptom resolution after operative management of complications from transvaginal mesh. Obstet Gynecol. 2014;123(1):134\u20139.","journal-title":"Obstet Gynecol"},{"issue":"2","key":"1192_CR19","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/nau.22922","volume":"35","author":"BT Haylen","year":"2016","unstructured":"Haylen BT, Maher CF, Barber MD, et al. An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Neurourol Urodyn. 2016;35(2):137\u201368.","journal-title":"Neurourol Urodyn"},{"issue":"3","key":"1192_CR20","doi-asserted-by":"publisher","first-page":"235.e1","DOI":"10.1016\/j.ajog.2010.03.030","volume":"203","author":"K Nieminen","year":"2010","unstructured":"Nieminen K, Hiltunen R, Takala T, et al. Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. Am J Obstet Gynecol. 2010;203(3):235.e1.","journal-title":"Am J Obstet Gynecol"},{"issue":"7","key":"1192_CR21","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1111\/jog.13654","volume":"44","author":"M Kinjo","year":"2018","unstructured":"Kinjo M, Yoshimura Y, Kitagawa Y, Okegawa T, Nutahara K. Sexual activity and quality of life in Japanese pelvic organ prolapse patients after transvaginal mesh surgery. J Obstet Gynaecol Re. 2018;44(7):1302\u20137.","journal-title":"J Obstet Gynaecol Re"},{"issue":"1","key":"1192_CR22","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1002\/nau.21036","volume":"30","author":"BT Haylen","year":"2011","unstructured":"Haylen BT, Freeman RM, Swift SE, et al. An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Neurourol Urodyn. 2011;30(1):2\u201312.","journal-title":"Neurourol Urodyn"},{"issue":"10","key":"1192_CR23","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1007\/s00192-012-1706-2","volume":"23","author":"KP Gold","year":"2012","unstructured":"Gold KP, Ward RM, Zimmerman CW, et al. Factors associated with exposure of transvaginally placed polypropylene mesh for pelvic organ prolapse. Int Urogynecol J. 2012;23(10):1461\u20136.","journal-title":"Int Urogynecol J"},{"issue":"10067","key":"1192_CR24","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/S0140-6736(16)31596-3","volume":"389","author":"CM Glazener","year":"2017","unstructured":"Glazener CM, Breeman S, Elders A, et al. Mesh, graft, or standard repair for women having primary transvaginal anterior or posterior compartment prolapse surgery: two parallel-group, multicentre, randomised, controlled trials (PROSPECT). Lancet. 2017;389(10067):381\u201392.","journal-title":"Lancet"},{"issue":"8","key":"1192_CR25","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1111\/1471-0528.15148","volume":"125","author":"GW Cundiff","year":"2018","unstructured":"Cundiff GW, Quinlan DJ, van Rensburg JA, Slack M. Foundation for an evidence-informed algorithm for treating pelvic floor mesh complications: a review. BJOG. 2018;125(8):1026\u201337.","journal-title":"BJOG"},{"issue":"1","key":"1192_CR26","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.urology.2012.07.098","volume":"81","author":"D Lee","year":"2013","unstructured":"Lee D, Dillon B, Lemack G, Gomelsky A, Zimmern P. Transvaginal mesh kits-how \u201cserious\u201d are the complications and are they reversible? Urology. 2013;81(1):43\u20138.","journal-title":"Urology"},{"issue":"10","key":"1192_CR27","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1007\/s00192-012-1746-7","volume":"23","author":"ST Jeffrey","year":"2012","unstructured":"Jeffrey ST, Nieuwoudt A. Beyond the complications: medium-term anatomical, sexual and functional outcomes following removal of trocar-guided transvaginal mesh. A retrospective cohort study. Int Urogynecol J. 2012;23(10):1391\u20136.","journal-title":"Int Urogynecol J"},{"issue":"3","key":"1192_CR28","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1111\/j.1743-6109.2007.00761.x","volume":"5","author":"TY Rosenbaum","year":"2008","unstructured":"Rosenbaum TY, Owens A. The role of pelvic floor physical therapy in the treatment of pelvic and genital pain-related sexual dysfunction (CME). J Sex Med. 2008;5(3):513\u201323.","journal-title":"J Sex Med"},{"issue":"2","key":"1192_CR29","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1016\/j.ejogrb.2012.03.002","volume":"162","author":"N Marcus-Braun","year":"2012","unstructured":"Marcus-Braun N, Bourret A, von Theobald P. Persistent pelvic pain following transvaginal mesh surgery: a cause for mesh removal. Eur J Obstet Gynecol Reprod Biol. 2012;162(2):224\u20138.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"2","key":"1192_CR30","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1097\/AOG.0b013e3181cbca4d","volume":"115","author":"B Feiner","year":"2010","unstructured":"Feiner B, Maher C. Vaginal mesh contraction: definition, clinical presentation, and management. Obstet Gynecol. 2010;115(2):325\u201330.","journal-title":"Obstet Gynecol"},{"key":"1192_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/5727165","volume":"2018","author":"SG Vitale","year":"2018","unstructured":"Vitale SG, Lagana AS, Noventa M, et al. Transvaginal bilateral sacrospinous fixation after second recurrence of vaginal vault prolapse: efficacy and impact on quality of life and sexuality. Biomed Res Int. 2018;2018:1\u20136.","journal-title":"Biomed Res Int"},{"issue":"12","key":"1192_CR32","doi-asserted-by":"publisher","first-page":"1767","DOI":"10.1007\/s00192-017-3493-2","volume":"28","author":"ALWM Coolen","year":"2018","unstructured":"Coolen ALWM, Bui BN, Dietz V, et al. The treatment of post-hysterectomy vaginal vault prolapse: a systematic review and meta-analysis. Int Urogynecol J. 2018;28(12):1767\u201383.","journal-title":"Int Urogynecol J"},{"issue":"11","key":"1192_CR33","doi-asserted-by":"publisher","first-page":"1815","DOI":"10.1007\/s00192-013-2172-1","volume":"24","author":"MD Barber","year":"2013","unstructured":"Barber MD, Maher C. Apical prolapse. Int Urogynecol J. 2013;24(11):1815\u201333.","journal-title":"Int Urogynecol J"},{"issue":"2","key":"1192_CR34","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1080\/0167482X.2017.1294155","volume":"39","author":"AS Lagana","year":"2018","unstructured":"Lagana AS, La Rosa VL, Rapisarda AMC, Vitale SG. Pelvic organ prolapse: the impact on quality of life and psychological well-being. J Psychosom Obst Gynecol. 2018;39(2):164\u20136.","journal-title":"J Psychosom Obst Gynecol"},{"issue":"8","key":"1192_CR35","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1007\/s00192-018-3587-5","volume":"29","author":"D Altman","year":"2018","unstructured":"Altman D, Geale K, Falconer C, Morcos E. A generic health-related quality of life instrument for assessing pelvic organ prolapse surgery: correlation with condition-specific outcome measures. Int Urogynecol J. 2018;29(8):1093\u20139.","journal-title":"Int Urogynecol J"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-021-01192-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12905-021-01192-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-021-01192-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T08:03:40Z","timestamp":1611993820000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-021-01192-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,30]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1192"],"URL":"https:\/\/doi.org\/10.1186\/s12905-021-01192-w","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-38744\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-38744\/v2","asserted-by":"object"}]},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,30]]},"assertion":[{"value":"2 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The Ethics Committee of Shengjing Hospital of China Medical University approved this retrospective study, and granted the permission to access and use the medical records described in the study (No. 2019PS482K). As the study was based on data routinely collected from electronic medical records, no additional testing\/inspections were needed for patients who involved in the research, the Ethics Committee approved the waiver of informed consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"46"}}