Peer-reviewed veterinary case report
Risk factors for mesh erosion after midurethral sling surgery
By Priyatini T et al.·2026·Department of Obstetrics and Gynecology·View original on Europe PMC →
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Original publication title: Patient-Related Risk Factors for Mesh Erosion Following Midurethral Sling Procedures: A Systematic Review and Meta-Analysis.
Plain-English summary
This study looked at the risks of a complication called mesh erosion that can happen after a common surgery for stress urinary incontinence, which is when someone leaks urine during activities like coughing or sneezing. Researchers reviewed data from six high-quality studies involving over 3,000 patients and found that mesh erosion occurred in about 1.3% to 13.7% of cases. They identified several important risk factors for this complication, including having had previous pelvic surgery, being diabetic, smoking, being obese (with a body mass index of 30 or higher), and being postmenopausal (after menopause). The findings suggest that these factors should be considered when evaluating patients before surgery to help inform them about their risks. Overall, the study provides a solid basis for understanding who might be at higher risk for mesh erosion after this procedure.
Abstract
<h4>Introduction and hypothesis</h4>Midurethral slings (MUS) are among the most commonly performed surgical treatments for stress urinary incontinence (SUI) worldwide, but mesh erosion remains a concerning complication. This systematic review and meta-analysis aimed to identify patient-related risk factors associated with mesh erosion following MUS procedures.<h4>Methods</h4>We conducted a comprehensive literature search in MEDLINE via PubMed, ScienceDirect, and Scopus from January 2010 to March 2025. Studies reporting risk factors for mesh erosion following synthetic MUS procedures for SUI were included. Two independent reviewers assessed study quality using the Newcastle-Ottawa Scale. Evidence certainty was evaluated using the GRADE approach. Fixed-effects meta-analyses were performed to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs).<h4>Results</h4>Six high-quality studies (n = 3068 patients) were included. The prevalence of mesh erosion ranged from 1.3% to 13.7% across studies. Significant risk factors for mesh erosion included prior pelvic surgery (OR 10.37; 95% CI 6.70-16.07), diabetes mellitus (OR 4.63; 95% CI 3.44-6.25), smoking (OR 3.38; 95% CI 2.54-4.48), obesity (BMI ≥ 30 kg/m<sup>2</sup>) (OR 2.79; 95% CI 1.69-4.62), and postmenopausal status (OR 2.34; 95% CI 1.67-3.27). GRADE assessment indicated moderate-certainty evidence for prior pelvic surgery, diabetes mellitus, smoking, and postmenopausal status.<h4>Conclusions</h4>This meta-analysis identifies prior pelvic surgery, postmenopausal status, diabetes mellitus, smoking, and obesity (BMI ≥ 30 kg/m<sup>2</sup>) as significant risk factors for mesh erosion following MUS procedures. These findings provide an evidence-based foundation for preoperative risk stratification and patient counseling.<h4>Trial registartion</h4>Prospero CRD420251026364.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41603954