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stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng123er12-lrg.png" alt="Cover of Evidence review for management of mesh complications" /></a></div><div class="bkr_bib"><h1 id="_NBK577729_"><span itemprop="name">Evidence review for management of mesh complications</span></h1><div class="subtitle">Urinary incontinence and pelvic organ prolapse in women: management</div><p><b>Evidence review L</b></p><p><i>NICE Guideline, No. 123</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Alliance (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2019 Apr</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3319-8</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div></div><div class="bkr_clear"></div></div><div id="ch12.s1"><h2 id="_ch12_s1_">Management of mesh complications</h2><div id="ch12.s1.1"><h3>Review questions</h3><p>This evidence report contains information on 5 evidence reviews relating to the management of mesh complications:
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<ul id="ch12.l1"><li id="ch12.lt1" class="half_rhythm"><div>What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</div></li><li id="ch12.lt2" class="half_rhythm"><div>What are the most effective management options for sexual dysfunction after mesh surgery?</div></li><li id="ch12.lt3" class="half_rhythm"><div>What are the most effective management options for pain after mesh surgery?</div></li><li id="ch12.lt4" class="half_rhythm"><div>What are the most effective management options for urinary complications after mesh surgery?</div></li><li id="ch12.lt5" class="half_rhythm"><div>What are the most effective management options for bowel symptoms after mesh surgery?</div></li></ul></p><div id="ch12.s1.1.1"><h4>Introduction</h4><p>Complications following surgery for urinary incontinence or pelvic organ prolapse (POP) using mesh can cause significant morbidity and may occur years after initial surgery. Mesh complications may occur after synthetic mid-urethral mesh sling surgery or vaginally or abdominally placed synthetic mesh for pelvic organ prolapse. These can include vaginal complications, such as exposure or extrusion, infection, sexual dysfunction, pain, as well as urinary and bowel complications. There is no consensus as to how these complications should be managed and whether removal of mesh, either partially or completely, is necessary.</p><p>A standardised approach to care would help to guide clinicians when managing such complex cases and ensure women receive appropriate care. The Mesh Oversight Group Report, July 2017, advised that women with mesh complications should be seen in a specialised mesh centre offering a multidisciplinary team approach consisting of urogynaecology, urology, specialist radiology, specialist pain management and specialist diagnostic medical / allied health professional team members. This review aims to determine the most effective management strategies for complications following mesh surgery.</p></div><div id="ch12.s1.1.2"><h4>Summary of the protocols</h4><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab1/?report=objectonly" target="object" rid-figpopup="figch12tab1" rid-ob="figobch12tab1">Table 1</a>, <a class="figpopup" href="/books/NBK577729/table/ch12.tab2/?report=objectonly" target="object" rid-figpopup="figch12tab2" rid-ob="figobch12tab2">Table 2</a>, <a class="figpopup" href="/books/NBK577729/table/ch12.tab3/?report=objectonly" target="object" rid-figpopup="figch12tab3" rid-ob="figobch12tab3">Table 3</a>, <a class="figpopup" href="/books/NBK577729/table/ch12.tab4/?report=objectonly" target="object" rid-figpopup="figch12tab4" rid-ob="figobch12tab4">Table 4</a> and <a class="figpopup" href="/books/NBK577729/table/ch12.tab5/?report=objectonly" target="object" rid-figpopup="figch12tab5" rid-ob="figobch12tab5">Table 5</a> present a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of the protocols for the 5 mesh complications reviews. These are related to the management of vaginal, sexual dysfunction, pain, urinary and bowel complications after mesh or mesh sling surgery respectively.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab1"><a href="/books/NBK577729/table/ch12.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab1" rid-ob="figobch12tab1"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab1/?report=thumb" src-large="/books/NBK577729/table/ch12.tab1/?report=previmg" alt="Table 1. Summary of protocol (PICO table) for management of vaginal complications after mesh or mesh sling surgery." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab1"><a href="/books/NBK577729/table/ch12.tab1/?report=objectonly" target="object" rid-ob="figobch12tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of protocol (PICO table) for management of vaginal complications after mesh or mesh sling surgery. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab2"><a href="/books/NBK577729/table/ch12.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab2" rid-ob="figobch12tab2"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab2/?report=thumb" src-large="/books/NBK577729/table/ch12.tab2/?report=previmg" alt="Table 2. Summary of protocol (PICO table) for management of sexual dysfunction complications after mesh or mesh sling surgery." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab2"><a href="/books/NBK577729/table/ch12.tab2/?report=objectonly" target="object" rid-ob="figobch12tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of protocol (PICO table) for management of sexual dysfunction complications after mesh or mesh sling surgery. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab3"><a href="/books/NBK577729/table/ch12.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab3" rid-ob="figobch12tab3"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab3/?report=thumb" src-large="/books/NBK577729/table/ch12.tab3/?report=previmg" alt="Table 3. Summary of protocol (PICO table) for management of pain complications after mesh or mesh sling surgery." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab3"><a href="/books/NBK577729/table/ch12.tab3/?report=objectonly" target="object" rid-ob="figobch12tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary of protocol (PICO table) for management of pain complications after mesh or mesh sling surgery. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab4"><a href="/books/NBK577729/table/ch12.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab4" rid-ob="figobch12tab4"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab4/?report=thumb" src-large="/books/NBK577729/table/ch12.tab4/?report=previmg" alt="Table 4. Summary of protocol (PICO table) for management of urinary complications after mesh or mesh sling surgery." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab4"><a href="/books/NBK577729/table/ch12.tab4/?report=objectonly" target="object" rid-ob="figobch12tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Summary of protocol (PICO table) for management of urinary complications after mesh or mesh sling surgery. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab5"><a href="/books/NBK577729/table/ch12.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab5" rid-ob="figobch12tab5"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab5/?report=thumb" src-large="/books/NBK577729/table/ch12.tab5/?report=previmg" alt="Table 5. Summary of protocol (PICO table) for management of bowel complications after mesh or mesh sling surgery." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab5"><a href="/books/NBK577729/table/ch12.tab5/?report=objectonly" target="object" rid-ob="figobch12tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Summary of protocol (PICO table) for management of bowel complications after mesh or mesh sling surgery. </p></div></div><p>For further details see review protocols in <a href="#ch12.appa">appendix A</a>.</p></div><div id="ch12.s1.1.3"><h4>Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#ch12.appa">appendix A</a> and appendix N (network meta-analysis). For a full description of the methods see supplementary material C</p><p>Declarations of interest were recorded according to NICE’s 2014 conflicts of interest policy until 31 March 2018. From 1 April 2018, declarations of interest were recorded according to NICE’s 2018 <a href="https://www.nice.org.uk/Media/Default/About/Who-we-are/Policies-and-procedures/declaring-and-managing-interests-board-and-employees.pdf" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">conflicts of interest policy</a>. Those interests declared until April 2018 were reclassified according to NICE’s 2018 conflicts of interest policy (see Register of Interests).</p></div><div id="ch12.s1.1.4"><h4>Clinical evidence</h4><div id="ch12.s1.1.4.1"><h5>Included studies</h5><p>Due to the paucity of available evidence for each individual complication, the committee decided to consider some of the excluded studies that did not strictly meet the inclusion criteria of the individual mesh complications reviews for in order to inform the recommendations about the management of mesh complications. As such, it was decided to include case series studies with more than 50 participants, reporting outcomes of women with a variety of mesh complications (see the ‘General section on mesh complications’ below).</p><p>For a summary of the included studies see <a class="figpopup" href="/books/NBK577729/table/ch12.tab6/?report=objectonly" target="object" rid-figpopup="figch12tab6" rid-ob="figobch12tab6">Tables 6</a> to <a class="figpopup" href="/books/NBK577729/table/ch12.tab12/?report=objectonly" target="object" rid-figpopup="figch12tab12" rid-ob="figobch12tab12">12</a>. See also the literature search strategies in <a href="#ch12.appb">appendix B</a>, study selection flow charts in <a href="#ch12.appc">appendix C</a>, study evidence tables in <a href="#ch12.appd">appendix D</a>, forest plots in <a href="#ch12.appe">appendix E</a> and GRADE tables in <a href="#ch12.appf">appendix F</a>.</p><div id="ch12.s1.1.4.1.1"><h5>Management of vaginal complications after mesh or mesh sling surgery</h5><p>No RCT were identified for this review. Five observational studies - 1 prospective cohort <a class="bibr" href="#ch12.s1.ref8" rid="ch12.s1.ref8">Domingo 2005</a>), 1 retrospective cohort (<a class="bibr" href="#ch12.s1.ref13" rid="ch12.s1.ref13">Jambusaria 2016</a>), and 3 case series (<a class="bibr" href="#ch12.s1.ref2" rid="ch12.s1.ref2">Begley 2005</a>; <a class="bibr" href="#ch12.s1.ref4" rid="ch12.s1.ref4">Cheng 2017</a>; <a class="bibr" href="#ch12.s1.ref15" rid="ch12.s1.ref15">Kohli 1998</a>) – were included in this review.</p><p>Two cohort studies compared partial to complete removal of a synthetic mesh sling in women with SUI and mesh sling erosion or exposure (<a class="bibr" href="#ch12.s1.ref8" rid="ch12.s1.ref8">Domingo 2005</a>; <a class="bibr" href="#ch12.s1.ref13" rid="ch12.s1.ref13">Jambusaria 2016</a>).</p><p>Two one-arm case series studies (<a class="bibr" href="#ch12.s1.ref2" rid="ch12.s1.ref2">Begley 2005</a>; <a class="bibr" href="#ch12.s1.ref15" rid="ch12.s1.ref15">Kohli 1998</a>) examined the management of mesh erosion by partial or complete removal in women with POP who had abdominal sacrocolpopexy</p><p>One case series study (<a class="bibr" href="#ch12.s1.ref4" rid="ch12.s1.ref4">Cheng 2017</a>) examined the management of mesh erosions by conservative management or if this failed mesh removal in women with greater than stage 1 POP-Q who had vaginal mesh kit repair.</p></div><div id="ch12.s1.1.4.1.2"><h5>Management of sexual dysfunction and pain complications after mesh or mesh sling surgery</h5><p>No RCT studies were identified for either of these reviews. Three observational studies - including one prospective cohort (<a class="bibr" href="#ch12.s1.ref12" rid="ch12.s1.ref12">Hou 2014</a>), one retrospective cohort (<a class="bibr" href="#ch12.s1.ref13" rid="ch12.s1.ref13">Jambusaria 2016</a>) and 1 single-arm case series study (<a class="bibr" href="#ch12.s1.ref7" rid="ch12.s1.ref7">Danford 2015</a>) were identified as relevant to this review.</p><p>All 3 studies examined synthetic mesh sling removal or mesh sling revision surgery in women with pain-related (including sexual dysfunction) complications after mesh sling surgery for treatment of SUI. No study was identified that was relevant only to the population of interest for the separate review questions.</p></div><div id="ch12.s1.1.4.1.3"><h5>Management of urinary complications after mesh or mesh sling surgery</h5><p>No RCT or cohort studies were identified for this review. One single-arm case series study (<a class="bibr" href="#ch12.s1.ref5" rid="ch12.s1.ref5">Crescenze 2016</a>) was identified that examined the management of mesh complications in women with a variety of lower urinary tract symptoms after mesh sling surgery for treatment of SUI.</p></div><div id="ch12.s1.1.4.1.4"><h5>Management of bowel complications after mesh or mesh sling surgery</h5><p>A systematic review of the clinical literature was conducted but no studies were identified which were applicable to this review question.</p></div><div id="ch12.s1.1.4.1.5"><h5>General management of mesh complications after mesh or mesh sling surgery</h5><p>Seventeen observational studies - 3 retrospective cohort (<a class="bibr" href="#ch12.s1.ref11" rid="ch12.s1.ref11">Hokenstad 2015</a>; <a class="bibr" href="#ch12.s1.ref22" rid="ch12.s1.ref22">Ramart 2017</a>; <a class="bibr" href="#ch12.s1.ref24" rid="ch12.s1.ref24">Shaw 2017</a>) and 14 case series (<a class="bibr" href="#ch12.s1.ref1" rid="ch12.s1.ref1">Abbott 2014</a>; <a class="bibr" href="#ch12.s1.ref3" rid="ch12.s1.ref3">Cardenas-Trowers 2017</a>; <a class="bibr" href="#ch12.s1.ref6" rid="ch12.s1.ref6">Crosby 2014</a>; <a class="bibr" href="#ch12.s1.ref9" rid="ch12.s1.ref9">Fabian 2015</a>; <a class="bibr" href="#ch12.s1.ref10" rid="ch12.s1.ref10">George 2013</a>; <a class="bibr" href="#ch12.s1.ref16" rid="ch12.s1.ref16">Lee 2013</a>; <a class="bibr" href="#ch12.s1.ref17" rid="ch12.s1.ref17">Marcus-Braun 2010</a>; <a class="bibr" href="#ch12.s1.ref18" rid="ch12.s1.ref18">Misrai 2009</a>; <a class="bibr" href="#ch12.s1.ref19" rid="ch12.s1.ref19">Parden. 2016</a>; <a class="bibr" href="#ch12.s1.ref20" rid="ch12.s1.ref20">Pickett 2015</a>; <a class="bibr" href="#ch12.s1.ref21" rid="ch12.s1.ref21">Rac 2017</a>; <a class="bibr" href="#ch12.s1.ref23" rid="ch12.s1.ref23">Renezeder 2011</a>; <a class="bibr" href="#ch12.s1.ref25" rid="ch12.s1.ref25">Skala 2011</a>; <a class="bibr" href="#ch12.s1.ref26" rid="ch12.s1.ref26">Warembourg 2017</a>) were identified that examined the treatment and management of women with SUI and/or POP who had complications after the insertion of mesh or mesh sling. The participants in these studies were referred for treatment because of a variety of mesh related complications, with the majority of treatments consisting of mesh (e.g. revision or removal) surgery. Most studies had a follow up of less than 12 months.</p><p>Three retrospective cohort studies (<a class="bibr" href="#ch12.s1.ref11" rid="ch12.s1.ref11">Hokenstad 2015</a>; Ramart 2015; <a class="bibr" href="#ch12.s1.ref24" rid="ch12.s1.ref24">Shaw 2017</a>) were identified that examined different types of mesh surgery in women with pure SUI, stress-predominant mixed UI, and/or POP. Two of the retrospective cohort studies (<a class="bibr" href="#ch12.s1.ref24" rid="ch12.s1.ref24">Shaw 2017</a>; <a class="bibr" href="#ch12.s1.ref22" rid="ch12.s1.ref22">Ramart 2017</a>) examined surgery to treat mesh complications in women who had previously had synthetic mesh sling inserted to treat SUI, with one study comparing mesh sling division to mesh sling removal, whilst the other compared the removal of retropubic synthetic mesh slings to that of transobturator synthetic mesh slings. The other study (<a class="bibr" href="#ch12.s1.ref11" rid="ch12.s1.ref11">Hokenstad 2015</a>) compared partial removal to complete removal of vaginally-placed mesh for the treatment of women with POP.</p><p>The majority of the participants in the case series studies had partial or complete mesh or mesh sling removal surgery and were referred for mesh surgery for the treatment and management of more than one complication.</p></div></div><div id="ch12.s1.1.4.2"><h5>Excluded studies</h5><p>Studies not included in this review with reasons for their exclusion are provided in <a href="#ch12.appk">appendix K</a>. For a list of excluded studies relevant to the general sections on the management of mesh complications, please see the excluded studies lists of the individual reviews in <a href="#ch12.appk">appendix K</a>.</p></div></div><div id="ch12.s1.1.5"><h4>Summary of clinical studies included in this review</h4><div id="ch12.s1.1.5.1"><h5>Summary of cohort studies included in the evidence review</h5><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab6/?report=objectonly" target="object" rid-figpopup="figch12tab6" rid-ob="figobch12tab6">Table 6</a> provides a brief summary of the 2 included cohort studies (<a class="bibr" href="#ch12.s1.ref8" rid="ch12.s1.ref8">Domingo 2005</a>; <a class="bibr" href="#ch12.s1.ref13" rid="ch12.s1.ref13">Jambusaria 2016</a>) in the review of the management of vaginal complications after mesh or mesh sling surgery, both of which compared partial to complete vaginal mesh removal in women after mesh surgery for treatment of POP.</p><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab10/?report=objectonly" target="object" rid-figpopup="figch12tab10" rid-ob="figobch12tab10">Table <b>10</b></a> provides a brief summary of the 2 included cohort studies in the review of the management of sexual dysfunction and/or pain complications (<a class="bibr" href="#ch12.s1.ref12" rid="ch12.s1.ref12">Hou 2014</a>; <a class="bibr" href="#ch12.s1.ref13" rid="ch12.s1.ref13">Jambusaria 2016</a>), both of which compared partial to complete mesh sling removal in women with sexual dysfunction and/or pain complications after mesh sling surgery for treatment of SUI.</p><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab15/?report=objectonly" target="object" rid-figpopup="figch12tab15" rid-ob="figobch12tab15">Table 15</a> provides a brief summary of the 1 included retrospective cohort study (<a class="bibr" href="#ch12.s1.ref11" rid="ch12.s1.ref11">Hokenstad 2015</a>) in the review of the general management of complications after mesh surgery that compared partial to complete removal of mesh in women who had vaginally-placed mesh for the treatment of POP.</p><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab16/?report=objectonly" target="object" rid-figpopup="figch12tab16" rid-ob="figobch12tab16">Table 16</a> provides a brief summary of the 1 included retrospective cohort study (<a class="bibr" href="#ch12.s1.ref24" rid="ch12.s1.ref24">Shaw 2017</a>) in the review of the general management of complications after mesh sling surgery that compared mesh division to partial or complete removal of mesh in women who had synthetic mesh sling for the treatment of SUI. See <a href="#ch12.appd">appendix D</a> for full evidence tables.</p><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab17/?report=objectonly" target="object" rid-figpopup="figch12tab17" rid-ob="figobch12tab17">Table 17</a> provides a brief summary of the 1 included retrospective cohort study (<a class="bibr" href="#ch12.s1.ref22" rid="ch12.s1.ref22">Ramart 2017</a>) in the review of the general management of complications after mesh sling surgery that compared removal of transobturator mesh sling to that of retropubic mesh sling in women who had synthetic mesh sling for the treatment of SUI. See <a href="#ch12.appd">appendix D</a> for full evidence tables.</p><p>See <a href="#ch12.appd">appendix D</a> for full evidence tables of included studies.</p></div><div id="ch12.s1.1.5.2"><h5>Summary of case series studies included in the evidence review</h5><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab7/?report=objectonly" target="object" rid-figpopup="figch12tab7" rid-ob="figobch12tab7">Table 7</a> lists the characteristics of the 3 case series studies included in the review of vaginal complications after mesh or mesh sling surgery (<a class="bibr" href="#ch12.s1.ref2" rid="ch12.s1.ref2">Begley 2005</a>; <a class="bibr" href="#ch12.s1.ref4" rid="ch12.s1.ref4">Cheng 2017</a>; <a class="bibr" href="#ch12.s1.ref15" rid="ch12.s1.ref15">Kohli 1998</a>), and <a class="figpopup" href="/books/NBK577729/table/ch12.tab8/?report=objectonly" target="object" rid-figpopup="figch12tab8" rid-ob="figobch12tab8">Table 8</a> provides a summary of the results.</p><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab11/?report=objectonly" target="object" rid-figpopup="figch12tab11" rid-ob="figobch12tab11">Table 11</a> lists the characteristics of the 1 case series study (<a class="bibr" href="#ch12.s1.ref6" rid="ch12.s1.ref6">Crosby 2014</a>) identified for the review of the management of sexual dysfunction and/or pain complications after mesh or mesh sling surgery, and <a class="figpopup" href="/books/NBK577729/table/ch12.tab12/?report=objectonly" target="object" rid-figpopup="figch12tab12" rid-ob="figobch12tab12">Table 12</a> provides a summary of the results</p><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab13/?report=objectonly" target="object" rid-figpopup="figch12tab13" rid-ob="figobch12tab13">Table 13</a> lists the characteristics of the 1 case series study (Crescenze 2014) identified for the review of the management of urinary complications after mesh or mesh sling surgery, and <a class="figpopup" href="/books/NBK577729/table/ch12.tab14/?report=objectonly" target="object" rid-figpopup="figch12tab14" rid-ob="figobch12tab14">Table 14</a> provides a summary of the results.</p><p><a class="figpopup" href="/books/NBK577729/table/ch12.tab18/?report=objectonly" target="object" rid-figpopup="figch12tab18" rid-ob="figobch12tab18">Table 18</a> lists the characteristics of the 14 case series studies included in the review of the general management of mesh complications after mesh or mesh sling surgery (<a class="bibr" href="#ch12.s1.ref1" rid="ch12.s1.ref1">Abbott 2014</a>; <a class="bibr" href="#ch12.s1.ref3" rid="ch12.s1.ref3">Cardenas-Trowers 2017</a>; <a class="bibr" href="#ch12.s1.ref6" rid="ch12.s1.ref6">Crosby 2014</a>; <a class="bibr" href="#ch12.s1.ref9" rid="ch12.s1.ref9">Fabian 2015</a>; <a class="bibr" href="#ch12.s1.ref10" rid="ch12.s1.ref10">George 2013</a>; <a class="bibr" href="#ch12.s1.ref16" rid="ch12.s1.ref16">Lee 2013</a>; <a class="bibr" href="#ch12.s1.ref17" rid="ch12.s1.ref17">Marcus-Braun 2010</a>; <a class="bibr" href="#ch12.s1.ref18" rid="ch12.s1.ref18">Misrai 2009</a>; <a class="bibr" href="#ch12.s1.ref19" rid="ch12.s1.ref19">Parden. 2016</a>; <a class="bibr" href="#ch12.s1.ref20" rid="ch12.s1.ref20">Pickett 2015</a>; <a class="bibr" href="#ch12.s1.ref21" rid="ch12.s1.ref21">Rac 2017</a>; <a class="bibr" href="#ch12.s1.ref23" rid="ch12.s1.ref23">Renezeder 2011</a>; <a class="bibr" href="#ch12.s1.ref25" rid="ch12.s1.ref25">Skala 2011</a>; <a class="bibr" href="#ch12.s1.ref26" rid="ch12.s1.ref26">Warembourg 2017</a>), whilst <a class="figpopup" href="/books/NBK577729/table/ch12.tab19/?report=objectonly" target="object" rid-figpopup="figch12tab19" rid-ob="figobch12tab19">Table 19</a> provides a summary of the results.</p><p>See <a href="#ch12.appd">appendix D</a> for full evidence tables of all included studies.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab6"><a href="/books/NBK577729/table/ch12.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab6" rid-ob="figobch12tab6"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab6/?report=thumb" src-large="/books/NBK577729/table/ch12.tab6/?report=previmg" alt="Table 6. Summary of included studies for complete mesh vaginal removal versus partial mesh vaginal removal in review of management of vaginal complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab6"><a href="/books/NBK577729/table/ch12.tab6/?report=objectonly" target="object" rid-ob="figobch12tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Summary of included studies for complete mesh vaginal removal versus partial mesh vaginal removal in review of management of vaginal complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab7"><a href="/books/NBK577729/table/ch12.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab7" rid-ob="figobch12tab7"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab7/?report=thumb" src-large="/books/NBK577729/table/ch12.tab7/?report=previmg" alt="Table 7. Study characteristics of case series studies in review of management of vaginal mesh complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab7"><a href="/books/NBK577729/table/ch12.tab7/?report=objectonly" target="object" rid-ob="figobch12tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Study characteristics of case series studies in review of management of vaginal mesh complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab8"><a href="/books/NBK577729/table/ch12.tab8/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab8" rid-ob="figobch12tab8"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab8/?report=thumb" src-large="/books/NBK577729/table/ch12.tab8/?report=previmg" alt="Table 8. Outcomes of case series studies on mesh removal in women who had abdominal sacrocolpopexy for treatment of POP." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab8"><a href="/books/NBK577729/table/ch12.tab8/?report=objectonly" target="object" rid-ob="figobch12tab8">Table 8</a></h4><p class="float-caption no_bottom_margin">Outcomes of case series studies on mesh removal in women who had abdominal sacrocolpopexy for treatment of POP. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab9"><a href="/books/NBK577729/table/ch12.tab9/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab9" rid-ob="figobch12tab9"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab9/?report=thumb" src-large="/books/NBK577729/table/ch12.tab9/?report=previmg" alt="Table 9. Outcomes of case series studies on mesh removal in women who had vaginal mesh kit for treatment of POP." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab9"><a href="/books/NBK577729/table/ch12.tab9/?report=objectonly" target="object" rid-ob="figobch12tab9">Table 9</a></h4><p class="float-caption no_bottom_margin">Outcomes of case series studies on mesh removal in women who had vaginal mesh kit for treatment of POP. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab10"><a href="/books/NBK577729/table/ch12.tab10/?report=objectonly" target="object" title="Table 10" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab10" rid-ob="figobch12tab10"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab10/?report=thumb" src-large="/books/NBK577729/table/ch12.tab10/?report=previmg" alt="Table 10. Summary of included studies for complete mesh sling removal versus partial mesh sling removal in review of management of sexual dysfunction and/or pain mesh complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab10"><a href="/books/NBK577729/table/ch12.tab10/?report=objectonly" target="object" rid-ob="figobch12tab10">Table 10</a></h4><p class="float-caption no_bottom_margin">Summary of included studies for complete mesh sling removal versus partial mesh sling removal in review of management of sexual dysfunction and/or pain mesh complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab11"><a href="/books/NBK577729/table/ch12.tab11/?report=objectonly" target="object" title="Table 11" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab11" rid-ob="figobch12tab11"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab11/?report=thumb" src-large="/books/NBK577729/table/ch12.tab11/?report=previmg" alt="Table 11. Study characteristics of case series studies in review of management of pain and/or sexual dysfunction complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab11"><a href="/books/NBK577729/table/ch12.tab11/?report=objectonly" target="object" rid-ob="figobch12tab11">Table 11</a></h4><p class="float-caption no_bottom_margin">Study characteristics of case series studies in review of management of pain and/or sexual dysfunction complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab12"><a href="/books/NBK577729/table/ch12.tab12/?report=objectonly" target="object" title="Table 12" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab12" rid-ob="figobch12tab12"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab12/?report=thumb" src-large="/books/NBK577729/table/ch12.tab12/?report=previmg" alt="Table 12. Pain status outcomes after mesh surgery (sling division or mesh sling removal) in women with or without mesh exposure." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab12"><a href="/books/NBK577729/table/ch12.tab12/?report=objectonly" target="object" rid-ob="figobch12tab12">Table 12</a></h4><p class="float-caption no_bottom_margin">Pain status outcomes after mesh surgery (sling division or mesh sling removal) in women with or without mesh exposure. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab13"><a href="/books/NBK577729/table/ch12.tab13/?report=objectonly" target="object" title="Table 13" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab13" rid-ob="figobch12tab13"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab13/?report=thumb" src-large="/books/NBK577729/table/ch12.tab13/?report=previmg" alt="Table 13. Study characteristics of case series studies in review of management of urinary mesh complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab13"><a href="/books/NBK577729/table/ch12.tab13/?report=objectonly" target="object" rid-ob="figobch12tab13">Table 13</a></h4><p class="float-caption no_bottom_margin">Study characteristics of case series studies in review of management of urinary mesh complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab14"><a href="/books/NBK577729/table/ch12.tab14/?report=objectonly" target="object" title="Table 14" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab14" rid-ob="figobch12tab14"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab14/?report=thumb" src-large="/books/NBK577729/table/ch12.tab14/?report=previmg" alt="Table 14. Outcomes of mesh surgery to resolve urinary mesh sling complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab14"><a href="/books/NBK577729/table/ch12.tab14/?report=objectonly" target="object" rid-ob="figobch12tab14">Table 14</a></h4><p class="float-caption no_bottom_margin">Outcomes of mesh surgery to resolve urinary mesh sling complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab15"><a href="/books/NBK577729/table/ch12.tab15/?report=objectonly" target="object" title="Table 15" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab15" rid-ob="figobch12tab15"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab15/?report=thumb" src-large="/books/NBK577729/table/ch12.tab15/?report=previmg" alt="Table 15. Study characteristics of included cohort studies for partial versus complete mesh removal in review of management of mesh complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab15"><a href="/books/NBK577729/table/ch12.tab15/?report=objectonly" target="object" rid-ob="figobch12tab15">Table 15</a></h4><p class="float-caption no_bottom_margin">Study characteristics of included cohort studies for partial versus complete mesh removal in review of management of mesh complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab16"><a href="/books/NBK577729/table/ch12.tab16/?report=objectonly" target="object" title="Table 16" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab16" rid-ob="figobch12tab16"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab16/?report=thumb" src-large="/books/NBK577729/table/ch12.tab16/?report=previmg" alt="Table 16. Study characteristics of included cohort studies for mesh division versus complete or partial mesh removal in review of management of mesh sling complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab16"><a href="/books/NBK577729/table/ch12.tab16/?report=objectonly" target="object" rid-ob="figobch12tab16">Table 16</a></h4><p class="float-caption no_bottom_margin">Study characteristics of included cohort studies for mesh division versus complete or partial mesh removal in review of management of mesh sling complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab17"><a href="/books/NBK577729/table/ch12.tab17/?report=objectonly" target="object" title="Table 17" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab17" rid-ob="figobch12tab17"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab17/?report=thumb" src-large="/books/NBK577729/table/ch12.tab17/?report=previmg" alt="Table 17. Study characteristics of included cohort studies for removal of synthetic transobturator versus retropubic mesh sling for management of women with mesh complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab17"><a href="/books/NBK577729/table/ch12.tab17/?report=objectonly" target="object" rid-ob="figobch12tab17">Table 17</a></h4><p class="float-caption no_bottom_margin">Study characteristics of included cohort studies for removal of synthetic transobturator versus retropubic mesh sling for management of women with mesh complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab18"><a href="/books/NBK577729/table/ch12.tab18/?report=objectonly" target="object" title="Table 18" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab18" rid-ob="figobch12tab18"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab18/?report=thumb" src-large="/books/NBK577729/table/ch12.tab18/?report=previmg" alt="Table 18. Study characteristics of included case series studies on the general management of mesh complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab18"><a href="/books/NBK577729/table/ch12.tab18/?report=objectonly" target="object" rid-ob="figobch12tab18">Table 18</a></h4><p class="float-caption no_bottom_margin">Study characteristics of included case series studies on the general management of mesh complications. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12tab19"><a href="/books/NBK577729/table/ch12.tab19/?report=objectonly" target="object" title="Table 19" class="img_link icnblk_img figpopup" rid-figpopup="figch12tab19" rid-ob="figobch12tab19"><img class="small-thumb" src="/books/NBK577729/table/ch12.tab19/?report=thumb" src-large="/books/NBK577729/table/ch12.tab19/?report=previmg" alt="Table 19. Outcomes of surgery to resolve mesh complications for review of general management of complications." /></a><div class="icnblk_cntnt"><h4 id="ch12.tab19"><a href="/books/NBK577729/table/ch12.tab19/?report=objectonly" target="object" rid-ob="figobch12tab19">Table 19</a></h4><p class="float-caption no_bottom_margin">Outcomes of surgery to resolve mesh complications for review of general management of complications. </p></div></div></div></div></div><div id="ch12.s1.2"><h3>Quality assessment of studies included in the evidence review</h3><p>The Cochrane ROBINS-I checklist was used to assess the risk of bias for observational studies (e.g. cohort and case series studies). See <a href="#ch12.appf">appendix F</a> for the full GRADE table for comparative outcomes.</p><div id="ch12.s1.2.1"><h4>Economic evidence</h4><div id="ch12.s1.2.1.1"><h5>Included studies</h5><p>A systematic review of the economic literature was carried out but no studies were identified which were applicable to this review question. See supplementary material D for further information.</p></div><div id="ch12.s1.2.1.2"><h5>Excluded studies</h5><p>No studies were identified which were applicable to this review question.</p></div></div><div id="ch12.s1.2.2"><h4>Summary of studies included in the economic evidence review</h4><p>No economic evaluations were identified which were applicable to this review question.</p></div><div id="ch12.s1.2.3"><h4>Economic model</h4><p>This question was not prioritised for economic modelling because the evidence to base this on was anticipated to be limited.</p></div></div><div id="ch12.s1.3"><h3>Clinical evidence statements</h3><div id="ch12.s1.3.1"><h4>Management of vaginal complications after mesh sling surgery</h4><div id="ch12.s1.3.1.1"><h5>Partial vaginal mesh removal versus complete vaginal mesh removal</h5><div id="ch12.s1.3.1.1.1"><h5>Continued or repeated exposure/extrusion/infection</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.1.1.2"><h5>Adverse events</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.1.1.3"><h5>Complications at ≤1 year and >1 year</h5><ul id="ch12.l88"><li id="ch12.lt326" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=94) showed no clinically important difference between partial and complete vaginal mesh sling removal in women with vaginal mesh sling complications on pain (RR 0.4 [95% CI 0.12–1.33]) and de novo urgency (RR 0.81 [95% CI 0.33–1.96) at mean 5.9 weeks follow up.</div></li><li id="ch12.lt327" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=56) showed there may be a clinically important difference favouring partial over complete vaginal mesh sling removal in women with vaginal mesh sling complications on recurrent SUI at mean 28.6 weeks follow up, RR 0.36 (95% CI 0.11–1.16).</div></li><li id="ch12.lt328" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=56) showed no clinically important difference between partial and complete vaginal mesh sling removal in women with vaginal mesh sling complications on de novo urgency at mean 28.6 weeks follow up: RR 0.78 (95% CI 0.36–1.68).</div></li></ul></div><div id="ch12.s1.3.1.1.4"><h5>Health-related quality of life</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.1.1.5"><h5>Patient satisfaction</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.1.1.6"><h5>Repeat surgery</h5><ul id="ch12.l89"><li id="ch12.lt329" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=56) showed a clinically important difference favouring partial over complete vaginal mesh sling removal in women with vaginal mesh sling complications on repeat surgery for any reason at mean 28.6 weeks follow up: RR 0.19 (95% CI 0.05–0.76).</div></li></ul></div><div id="ch12.s1.3.1.1.7"><h5>Recurrent urinary incontinence or prolapse</h5><ul id="ch12.l90"><li id="ch12.lt330" class="half_rhythm"><div>Very low quality evidence from 2 observational cohort studies (n=65) showed a clinically important difference favouring partial over complete vaginal mesh sling removal in women with vaginal mesh sling complications on recurrent SUI: RR 0.33 (95% CI 0.15–0.71)</div></li></ul></div><div id="ch12.s1.3.1.1.8"><h5>Non-comparative data</h5><p>Data from 3 case series studies, all of which were at serious risk of bias, showed that
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<ul id="ch12.l91"><li id="ch12.lt331" class="half_rhythm"><div>The recurrent erosion rate in 1 case series study (n=5) of women who had vaginal mesh removal after abdominal sacrocolpopexy for prolapse was 0%; however, the rate of repeat surgery for mesh extrusion/exposure in the other case series study (n=7) was 57.1%</div></li><li id="ch12.lt332" class="half_rhythm"><div>The rate of POP recurrence in 1 case series study (n=7) of women who had vaginal mesh removal after abdominal sacrocolpopexy for prolapse at mean 15.5-month follow up was 29%.</div></li><li id="ch12.lt333" class="half_rhythm"><div>The rate of recurrent mesh extrusion/exposure and the rate of repeat surgery for mesh extrusion/exposure in 1 case series study (n=36) of women who had vaginal mesh removal after vaginal mesh kit for prolapse was 16.7%</div></li></ul>
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</p></div></div></div><div id="ch12.s1.3.2"><h4>Management of sexual dysfunction and/or pain complications after mesh or mesh sling surgery</h4><div id="ch12.s1.3.2.1"><h5>Partial mesh removal versus complete mesh sling removal</h5><div id="ch12.s1.3.2.1.1"><h5>Continued or repeated sexual dysfunction</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.1.2"><h5>Pain</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.1.3"><h5>Adverse events</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.1.4"><h5>Patient satisfaction</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.1.5"><h5>Health-related quality of life</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.1.6"><h5>Repeat surgery</h5><ul id="ch12.l92"><li id="ch12.lt334" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=92) showed no clinically important difference between partial and complete mesh sling removal for pain or dyspareunia in women with SUI who need repeat surgery for SUI at mean 29 weeks follow up: RR 2.6 (95% CI 0.7–9.7).</div></li></ul></div><div id="ch12.s1.3.2.1.7"><h5>Complications</h5><ul id="ch12.l93"><li id="ch12.lt335" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=151) showed no clinically important difference between partial and complete mesh sling removal for pain and/or sexual dysfunction in women with SUI on postoperative pain (RR 0.86 [95% CI 0.41–1.83]) urge incontinence (RR 0.51 [95% CI 0.23–1.16]) at mean 6.4 weeks follow up.</div></li><li id="ch12.lt336" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=92) showed no clinically important difference between partial and complete mesh sling removal for pain or dyspareunia in women with SUI on postoperative pain (RR 0.56 [95% CI 0.2–1.58]) and urge incontinence (RR 0.7 [95% CI 0.29–1.66]) at a mean 29 weeks follow up.</div></li></ul></div><div id="ch12.s1.3.2.1.8"><h5>Recurrent urinary incontinence or prolapse</h5><ul id="ch12.l94"><li id="ch12.lt337" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=151) showed no clinically important difference between partial and complete mesh sling removal for pain and/or sexual dysfunction on the number of women who have SUI at mean 6.4 weeks follow up: RR 0.65 (95% CI 0.36–1.18).</div></li><li id="ch12.lt338" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=92) showed there may be a clinically important difference favouring partial over complete mesh sling removal for pain and/or sexual dysfunction in women with SUI on recurrent SUI at mean 29 weeks follow up: RR 0.44 (95% CI 0.19–1.02).</div></li></ul></div></div><div id="ch12.s1.3.2.2"><h5>Mesh for prolapse versus mesh sling for SUI</h5><div id="ch12.s1.3.2.2.1"><h5>Continued or repeated sexual dysfunction</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.2.2"><h5>Pain</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.2.3"><h5>Adverse events</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.2.4"><h5>Patient satisfaction</h5><ul id="ch12.l95"><li id="ch12.lt339" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=123) showed there may be a clinically important difference favouring removal of mesh sling for SUI over removal of mesh for prolapse on the number of women with SUI and/or POP whose pain is resolved (RR 0.82 [95% CI 0.66–1.01]) and the number of women who have persistent pain (RR 2.87 [95% CI 0.84–9.78]) at mean 3 years follow up.</div></li></ul></div><div id="ch12.s1.3.2.2.5"><h5>Health-related quality of life</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.2.6"><h5>Repeat surgery</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.2.7"><h5>Complications at ≤1 year and >1 year</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.2.2.8"><h5>Recurrent urinary incontinence or prolapse</h5><p>No evidence was identified to inform this outcome.</p></div></div><div id="ch12.s1.3.2.3"><h5>Non-comparative data</h5><p>Data from 1 case series study (n=233), which was at serious risk of bias, of women who had mesh removal surgery for the treatment of sexual dysfunction and/or pain complications showed that
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<ul id="ch12.l96"><li id="ch12.lt340" class="half_rhythm"><div>77% of women who had concurrent mesh exposure showed an improvement in pain compared to 67% of those who did not.</div></li><li id="ch12.lt341" class="half_rhythm"><div>18% of women who had concurrent mesh exposure showed no change in pain compared to 5% of those that did not.</div></li><li id="ch12.lt342" class="half_rhythm"><div>5% of women who had concurrent mesh exposure showed a worsening of pain compared to 12% of those that did not.</div></li></ul>
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</p></div></div><div id="ch12.s1.3.3"><h4>Management of urinary complications after mesh or mesh sling surgery</h4><div id="ch12.s1.3.3.1"><h5>Non-comparative data</h5><p>Data from 1 cases series study (n=107), which was at serious risk of bias, of women that had mesh revision or mesh removal surgery after mesh sling for SUI showed that
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<ul id="ch12.l97"><li id="ch12.lt343" class="half_rhythm"><div>78.9% of the women no longer had obstructive voiding symptoms, 95.8% no longer needed to use a catheter, and 65.8% no longer had recurrent UTI.</div></li><li id="ch12.lt344" class="half_rhythm"><div>57% of the women had SUI (35.5% de novo).</div></li></ul>
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</p></div></div><div id="ch12.s1.3.4"><h4>General management of complications after mesh or mesh sling surgery</h4><div id="ch12.s1.3.4.1"><h5>Partial mesh removal versus complete mesh removal</h5><div id="ch12.s1.3.4.1.1"><h5>Adverse events</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.1.2"><h5>Complications</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.1.3"><h5>Health-related quality of life</h5><ul id="ch12.l98"><li id="ch12.lt345" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=41) showed a clinically important difference favouring complete mesh removal over partial mesh removal on the number of women with POP who show an improvement on the mental component of the SF-12 (Medical Outcomes Study Short Form) at range 4 to 14 years follow up: MD −8.92 (95% CI −14.19 to −3.65).</div></li><li id="ch12.lt346" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=41) showed no clinically important difference between partial and complete mesh removal on the number of women with POP who show an improvement on either the physical component of the SF-12 (Medical Outcomes Study Short Form; MD +0.56 [95% CI −7.13 to +8.25]) or the PFDI-SF 20 (Pelvic Floor Distress Inventory Short Form; MD −27.95 [95% CI −60.67 to +4.77]) at range 4 to 14 years follow up.</div></li><li id="ch12.lt347" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=33) showed no clinically important difference between partial and complete mesh removal on the number of women with POP who are sexually active and experience dyspareunia at range 4 to 14 years follow up RR 1.0 (0.7–1.42).</div></li></ul></div><div id="ch12.s1.3.4.1.4"><h5>Patient-satisfaction</h5><ul id="ch12.l99"><li id="ch12.lt348" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=41) showed no clinically important difference between partial and complete mesh removal on the number of women with POP who show an improvement in mesh complications at range 4 to 14 years follow up: RR 0.66 (95% CI 0.34–1.26)</div></li></ul></div><div id="ch12.s1.3.4.1.5"><h5>Repeat surgery</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.1.6"><h5>Recurrence of urinary incontinence or prolapse</h5><p>No evidence was identified to inform this outcome.</p></div></div><div id="ch12.s1.3.4.2"><h5>Mesh division versus mesh removal</h5><div id="ch12.s1.3.4.2.1"><h5>Adverse events</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.2.2"><h5>Complications</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.2.3"><h5>Health-related quality of life</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.2.4"><h5>Patient-satisfaction</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.2.5"><h5>Repeat surgery</h5><ul id="ch12.l100"><li id="ch12.lt349" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=102) showed a clinically important difference favouring mesh sling division over mesh sling removal on the number of women who have repeat surgery for SUI at range 1.5 to 48 months follow up: RR 0.16 (95% CI0.04–0.65).</div></li></ul></div><div id="ch12.s1.3.4.2.6"><h5>Recurrence of urinary incontinence or prolapse</h5><ul id="ch12.l101"><li id="ch12.lt350" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=102) showed a clinically important difference favouring mesh sling division over mesh sling removal on the number of women who have a recurrence of SUI at range 1.5 to 48 months follow up: RR 0.24 (95% CI0.11–0.52).</div></li></ul></div></div><div id="ch12.s1.3.4.3"><h5>Transobturator mesh sling removal versus retropubic mesh sling removal</h5><div id="ch12.s1.3.4.3.1"><h5>Adverse events</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.3.2"><h5>Complications</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.3.3"><h5>Health-related quality of life</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.3.4"><h5>Patient-satisfaction</h5><p>No evidence was identified to inform this outcome.</p></div><div id="ch12.s1.3.4.3.5"><h5>Repeat surgery</h5><ul id="ch12.l102"><li id="ch12.lt351" class="half_rhythm"><div>Very low quality evidence from 1 retrospective cohort study (n=117) showed no clinically important difference between the removal of transobturator mesh sling and retropubic mesh sling on the number of women with SUI who have repeat surgery for SUI at 3-months follow up: RR 0.88 (95% CI 0.54–1.45).</div></li></ul></div><div id="ch12.s1.3.4.3.6"><h5>Recurrence of urinary incontinence or prolapse</h5><p>No evidence was identified to inform this outcome.</p></div></div><div id="ch12.s1.3.4.4"><h5>Non-comparative data</h5></div><div id="ch12.s1.3.4.5"><h5>Mesh removal (partial or complete)</h5><p>Data, calculated as weighted averages, on the outcomes of mesh removal surgery to resolve mesh complications from 11 case series studies, all of which were at serious risk of bias, showed that:
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<ul id="ch12.l103"><li id="ch12.lt352" class="half_rhythm"><div>31.1% of women in 4 case series studies (n=257) no longer had any mesh complications;</div></li><li id="ch12.lt353" class="half_rhythm"><div>90.7% of women in 2 case series studies (n=86) no longer had mesh erosion/extrusion/exposure complications;</div></li><li id="ch12.lt354" class="half_rhythm"><div>58.4% of women in 5 case series studies (n=231) no longer had pain;</div></li><li id="ch12.lt355" class="half_rhythm"><div>32.3% of women in 4 case series studies (n=127) no longer had dyspareunia;</div></li><li id="ch12.lt356" class="half_rhythm"><div>37% of women in 2 case series studies (n=127) showed that 37% no longer had any urinary complication;</div></li><li id="ch12.lt357" class="half_rhythm"><div>63.6% of women in 1 case series studies (n=11) no longer had urgency urinary complications; had mesh removal to resolve mesh complications in 1 case series study (n=6) no longer had non-urgency urinary complications;</div></li><li id="ch12.lt358" class="half_rhythm"><div>100% of women in 1 case series study (n=7) no longer had bowel complications;</div></li><li id="ch12.lt359" class="half_rhythm"><div>3.4% of women in 4 case series studies (n=614) experienced an adverse event during mesh removal surgery;</div></li><li id="ch12.lt360" class="half_rhythm"><div>15.5% of women in 7 case series studies (n=728) had repeat surgery for any reason;</div></li><li id="ch12.lt361" class="half_rhythm"><div>24% of women in 1 case series study (n=75) had recurrent SUI;</div></li><li id="ch12.lt362" class="half_rhythm"><div>10.2% of women in 3 case series studies (n=177) had recurrent POP;</div></li><li id="ch12.lt363" class="half_rhythm"><div>11.9% of women in 2 case series studies (n=134) had a pain complication;</div></li><li id="ch12.lt364" class="half_rhythm"><div>6.7% of women in 1 case series study (n=12) had a fistula complication;</div></li><li id="ch12.lt365" class="half_rhythm"><div>11.9% of women in 2 case series studies (n=327) had an infection complication.</div></li></ul>
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</p></div><div id="ch12.s1.3.4.6"><h5>Various treatment strategies</h5><p>Data, calculated as weighted averages, on the outcomes of women who had general mesh surgery management from 4 case series studies, all of which were at serious risk of bias, showed that:
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<ul id="ch12.l104"><li id="ch12.lt366" class="half_rhythm"><div>1.0% of women in 2 case series studies (n=103) experienced an adverse event during general mesh surgery management;</div></li><li id="ch12.lt367" class="half_rhythm"><div>20.4% of women in 3 case series studies (n=450) had repeat surgery for any reason;</div></li><li id="ch12.lt368" class="half_rhythm"><div>16.9% of women in 1 case series study (n=83) had recurrent SUI;</div></li><li id="ch12.lt369" class="half_rhythm"><div>7.3% of women in 3 case series studies (n=138) had recurrent POP;</div></li><li id="ch12.lt370" class="half_rhythm"><div>18.2% of women in 2 case series studies (n=55) had a pain complication;</div></li><li id="ch12.lt371" class="half_rhythm"><div>0.8% of women in 2 case series studies (n=123) had a fistula complication;</div></li><li id="ch12.lt372" class="half_rhythm"><div>7.5% of women in 1 case series study (n=40) had an infection complication;</div></li><li id="ch12.lt373" class="half_rhythm"><div>0% of women in 1 case series study (n=40) had a wound complication.</div></li></ul>
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</p></div></div></div><div id="ch12.s1.4"><h3>Economic evidence statements</h3><p>No economic evidence on the cost effectiveness of interventions to manage mesh complications including mesh complications, vaginal complications, sexual dysfunction and pain, and urinary complications in women with UI, POP or both was available.</p><div id="ch12.s1.4.1"><h4>The committee’s discussion of the evidence</h4></div><div id="ch12.s1.4.2"><h4>Interpreting the evidence</h4><div id="ch12.s1.4.2.1"><h5>The outcomes that matter most</h5><p>The committee agreed that the critical outcomes for each review should be successful alleviation of the relevant mesh complication and the risks of adverse events for each intervention.</p><p>For the evidence review on the management of vaginal mesh complications, the committee agreed that continued or repeated exposure, extrusion or infection, adverse events, and complications more than 1 year after surgery, were the critical outcomes on which to base recommendations, and that validated measures of health-related quality of life, patient satisfaction, repeat surgery for mesh complications, and recurrence of urinary incontinence or prolapse were the most important.</p><p>For the evidence review on the management of sexual dysfunction, the committee agreed that continued or repeat sexual dysfunction, adverse events, and patient satisfaction were the critical outcomes on which to base recommendations, and that those of health-related quality of life, repeat surgery and complications >12 months were the most important. For the evidence review of the management of pain complications, the committee agreed that validated pain scales, patient satisfaction, adverse events, health-related quality of life, repeat surgery, complications >12-months and recurrence of UI or POP were the critical outcomes on which to base recommendations. But no studies were identified that used validated pain scales or reported continued or repeat sexual dysfunction</p><p>For the evidence review of the management of urinary complications, the committee agreed that the outcomes of continued or repeated urinary complications, adverse events, and complications >12 months were the critical outcomes on which to base recommendations, and that those of continence-specific health-related quality of life, patient satisfaction and repeat surgery were the most important.</p><p>For the evidence review on the management of bowel mesh complications, the committee agreed that reduction in bowel symptoms, adverse events, and health-related quality of life were the critical outcomes on which to base recommendations, and that those of complications, patient satisfaction, repeat surgery, and recurrence of urinary incontinence or prolapse were the most important.</p><p>For general management of mesh complications, the committee agreed that the outcomes common to all the reviews of specific mesh complications – persistence of symptoms, adverse events, repeat surgery, recurrent SUI/POP and complications of surgery to resolve mesh complications (pain, fistula, infection, and wound complications) were the most important on which to base recommendations.</p></div><div id="ch12.s1.4.2.2"><h5>The quality of the evidence</h5><p>Overall the quality of the evidence from the six cohort studies included for the five reviews was very low because only two of the relevant outcomes could be pooled, the observational nature of the data, and the confidence intervals associated with the effect estimates are relatively wide. Although the review found two observational cohort studies of women who had partial or complete vaginal mesh sling removal for the treatment of vaginal complications, pooling of the outcomes was only possible in one instance (recurrent SUI). No relevant evidence was found for the review on the management of bowel complications, but the committee agreed that the current NICE guideline CG49 on faecal incontinence should be followed. The committee acknowledged that there was currently no NICE guideline on the treatment of obstructive defecation but that locally-agreed protocols should be used. No relevant evidence was found involving interventions such as pus drainage, antibiotics, pain management, and those for the functional and non-functional bowel complications.</p><p>The 19 included case series studies were all assessed using the Cochrane ROBINS-I tool as being at serious risk of bias because of concerns over confounding, selection of participants, and measurement of outcome data. Sixteen studies examined mesh division, revision or removal, and three studies used more than two specific treatments. Fourteen of the 19 case series studies did not meet the inclusion criteria for the specific reviews. However, because of the paucity of data the committee decided to consider studies that included women referred for a variety of mesh complications.</p></div><div id="ch12.s1.4.2.3"><h5>Benefits and harms</h5><p>The limited available comparative evidence was observational in nature, mainly retrospective, of very low quality and limited to a short follow-up of one year and so could not support strong recommendations. Therefore the committee agreed that some of the studies that did not meet the inclusion criteria for the individual reviews but reported on the general management of mesh complications would be informative for their decision-making on the general management of mesh complications and the treatment of specific complications. The committee noted that the evidence from the included case series studies was wide-ranging, involving data from women with a variety of both mesh complications and associated synthetic mesh products, and accepted that the data were very uncertain. The committee agreed that the non-comparative data was consistent with both the comparative data and what would be clinically expected. They agreed that this suggested that mesh removal can sometimes resolve mesh complications but that its success varies widely with the specific mesh complication (e.g. vaginal, pain, urinary incontinence) and the complexity of the complications, and that some women who have complete removal of mesh will experience complications and recurrence of SUI and POP (or both), and need to have more surgery for these problems. The committee therefore based the majority of the recommendations on their expertise and experience and developed them by consensus.</p><div id="ch12.s1.4.2.3.1"><h5>General recommendations regarding management of mesh complications</h5><p>The committee discussed the difficulties involved in managing mesh complications. They noted that women often have multiple mesh complications, which can be long lasting and impacting on quality of life by affecting many activities of daily living. These require the input of many professionals during their treatment and management. The committee therefore agreed, based on their expertise and experience, that women who are contemplating mesh removal for mesh-related complications need the opportunity to discuss their own cases with relevant specialists of a regional or supra-regional MDT that can call on the relevant expertise to manage the specific complication(s).</p><p>The committee recognised that although removal of synthetic mesh may be the preferred option for some women who experience mesh complications, the evidence was not enough to recommend its use as a first-line treatment as a matter of course. To support shared decision-making women need to be informed of the possible risks and benefits of mesh removal surgery so that they can make an informed choice. The committee agreed that synthetic mesh material can be difficult to remove completely and that it is not always possible to do so, and that partial removal may be as effective. They also agreed that it was important to emphasise that partial or complete removal of mesh may lead to a recurrence of urinary incontinence or prolapse because the source of organ support has been removed.</p><p>Three retrospective cohort studies of women who had surgery to resolve a variety of mesh complications provided three individual comparisons. In addition to the study comparing mesh division to mesh removal, one study of women who had partial or complete mesh removal suggested an increased probability of having an improved ‘mental’ quality of life (SF-12 mental component score) for complete compared to partial removal, although there was no difference between them in improving mesh complications, improving physical quality of life (SF-12 physical component score), continence-specific health-related quality of life (PDFI-SF 20 score), and the number of women with dyspareunia. One study of women who had either transobturator or retropubic mesh sling removal surgery showed no difference between the two routes on the number of women who had repeat surgery for SUI.</p><p>The committee noted that the evidence on the comparison of complete to partial removal of mesh sling suggested that partial removal had an increased risk of pain at approximately 29 weeks follow up, an increased risk of recurrent SUI, and an increased risk that repeat surgery will be needed. The committee recognised that this is not unexpected because there may still be some support to the urethra after partial removal, and so the risk of recurrent SUI is likely to be lower than after complete removal. In contrast, one cohort study that examined partial compared to complete removal in women with mesh complications showed complete mesh removal was associated with an increased probability of an improvement in mental quality of life (SF-12 mental component score). The committee noted that this was a common clinical finding and interpreted it as possibly reflecting the psychological relief felt after the removal of the problematic synthetic mesh.</p></div><div id="ch12.s1.4.2.3.2"><h5>Management of vaginal complications</h5><p>On the management of vaginal complications, the committee noted that all the women in the included case series studies had unsuccessfully received conservative treatment before having surgery to resolve the complications. Given the limited evidence on the long-term effectiveness and safety of vaginal mesh removal, and based on their expertise and experience, the committee recommended that initial conservative treatment of an area of exposed mesh <1 cm<sup>2</sup> using topical vaginal oestrogen could be for at least 3 months before surgical options are considered. Although there was no evidence on the size of the mesh exposure that should be treated, the committee agreed, on the basis of their expertise and experience that vaginal oestrogen applied to exposed mesh with an area of ≥1cm<sup>2</sup> is not likely to be effective. Despite the limited evidence available, the committee wanted to make a relatively strong recommendation on the use of topical oestrogen cream. As it is a low risk intervention, it means the woman does not have to have surgery straight away, but if her exposure does not improve, she then has the option for further treatment. The committee noted that some women who present with mesh exposure/extrusion may experience vaginal discharge, which may be diagnosed as an infection rather than as a sign of exposure/extrusion. So, based on their expertise and experience, the committee recommended that in such cases, imaging should be offered in order to clarify the source of discharge.</p><p>Based on their experience and knowledge and decisions related to conservative treatment above, the committee decided that for women in whom conservative treatment has been unsuccessfully tried for 3 months or who have a mesh sling exposure or extrusion that is larger than ≥1cm<sup>2</sup> partial or complete removal of the vaginal portion of mesh sling should be considered.</p><p>In addition to the general recommendations on mesh removal (for example, that complete removal may not be possible), the committee agreed that some recommendations were needed on the specific type of vaginal mesh or mesh sling and condition (incontinence or prolapse) that women can present with. One cohort study comparing complete with partial vaginal mesh sling removal contributed most of the evidence and suggested there was an increased risk of pain at approximately 29 weeks follow up, recurrent SUI, and repeat surgery following complete removal, but no difference between the two on pain and de novo urgency at approximately 6 weeks and the latter at approximately 29 weeks follow up. The committee agreed that these results were consistent with their knowledge and experience and that it was important to tell women that there may be an increased risk of recurrent SUI with complete mesh sling removal compared to partial. Moreover, they agreed that there are a priori reasons to think that there will also be a decreased risk of subsequent mesh extrusion due to the simple fact that there will be less or no synthetic mesh material to support the urethra that can become extruded.</p><p>For mesh inserted to resolve prolapse or abdominally-placed mesh, the committee agreed that attempting the complete removal of mesh carries with it the inherent risk that prolapse will recur because of the lack of organ support. Consistent with this, one small case series study of less than 10 women, showed that almost 1 in 3 women had a recurrence of POP after complete mesh removal. Although there was no evidence on the risk of urinary tract and bowel injury following the attempted removal of either mesh for POP (e.g. transvaginal mesh kit) or abdominally-placed mesh to resolve vaginal complications, the committee agreed by consensus, based on their knowledge and experience, that there is a risk of these injuries because the urinary tract and bowel are very close to the mesh, which can make surgery difficult. Two small case series studies provided evidence on the rate of recurrent erosion associated with complete mesh removal after abdominal sacrocolpopexy, with one study reporting a rate of zero per cent and the other a rate over 50%. The committee agreed that this evidence was consistent with the difficulties associated with the attempt to completely remove synthetic mesh material. For abdominally-placed mesh in particular, the committee noted that abdominal surgery may be indicated if parts of the mesh are not accessible by other routes or if there is evidence of infection or there have been previous unsuccessful attempts to remove the mesh vaginally</p></div><div id="ch12.s1.4.2.3.3"><h5>Management of sexual dysfunction and/or pain complications</h5><p>The committee recognised that the management of sexual dysfunction and pain requires specialist assessment and agreed by consensus, based on their expertise and experience, that women who present with pain or painful sexual intercourse should be referred for this if they present in primary care. Even though evidence was limited the committee agreed (based on consensus) that this would be a strong recommendation for referral because of the impact that this complication has on the woman’s life. They furthermore agreed that if these symptoms are confirmed to be related to the insertion of synthetic mesh, then advice should be sought from a regional or supra-regional MDT.</p><p>One retrospective cohort study of women who had partial or complete mesh sling removal for treatment of sexual dysfunction and/or pain complications suggested no difference on the majority of outcomes (pain, urge incontinence, repeat surgery for SUI) at both approximately 6 and approximately 29 weeks follow up. However, the same study indicated that that there may also be an increased risk of postoperative SUI at approximately 29 weeks follow-up for complete compared to partial removal.</p><p>Evidence from another retrospective cohort study of women who had either mesh removal or mesh sling removal for treatment of sexual dysfunction and/or pain complications suggested that there is an increased probability of pain resolution and decreased risk of persistent pain when removing mesh sling for SUI compared to removing mesh for prolapse.</p><p>Given the relative lack of evidence, the committee agreed by consensus, using their knowledge and experience, that conservative treatments for pain and/or sexual dysfunction should be initially offered if no mesh abnormalities are detected and that advice from a regional or supra-regional MDT should be sought if these fail.</p></div><div id="ch12.s1.4.2.3.4"><h5>Management of urinary complications</h5><p>The committee discussed the complexities of managing urinary complications and agreed by consensus, using their knowledge and experience, that women who have mesh that is perforating the lower urinary tract should be referred to a mesh complications centre for assessment and management with the requisite expertise. They agreed that this should be a strong recommendation for referral, despite a lack of evidence, because of the impact that these complications have on women’s quality of life.</p><p>Given the uncertainty about the effectiveness and safety of mesh removal, the committee agreed by consensus that it was important that women are told that there is no guarantee that it will be successful in resolving urinary symptoms, that new symptoms or SUI may occur and indeed are more likely if removal is complete, and that there is a risk of both perioperative injury such as urinary tract fistula and repeat surgery.</p><p>The committee agreed that one retrospective cohort study of women with a variety of mesh complications, although not directly applicable to the review of urinary complications, was relevant to the recommendations. The study of women who had either mesh division or mesh removal showed an increased risk from the latter compared to the former on recurrence of SUI and risk of repeat surgery for SUI. The committee noted that almost all the women in whom mesh division was performed had voiding dysfunction, while those who had mesh removal had either mesh sling erosion or pain. Furthermore, they recognised that mesh division for the treatment of voiding dysfunction is standardly used to relieve tension in the mesh to permit successful voiding. The committee therefore agreed that mesh division, which can be performed in an outpatient setting, should be considered for resolving voiding dysfunction. However, they noted that women who had persistent voiding dysfunction should be referred to an appropriate mesh complications centre for appropriate diagnosis and management.</p><p>One case series study of women with lower urinary tract complications (e.g. obstructive voiding, recurrent urinary tract infection) who had either mesh revision or mesh removal suggested that the overall effectiveness of such surgeries for resolving specific urinary complications was variable and that there is some risk of persistent or de novo SUI. With this study in mind, the committee agreed by consensus, using their knowledge and experience, that it be explained to women considering surgery to resolve voiding symptoms that mesh removal has higher risk of recurrent SUI than mesh division and that further surgery may be needed.</p></div><div id="ch12.s1.4.2.3.5"><h5>Bowel complications</h5><p>On the treatment of bowel complications associated with mesh or mesh sling, the committee recognised that there is a dearth of evidence but agreed that functional bowel disorders should be managed according to the NICE CG49 guideline for faecal incontinence, and the management of obstructed defecation should follow locally-agreed protocols. In line with the recommendations on the general management of mesh complications, the committee agreed by consensus that an individualised treatment plan for women with non-functional bowel complications – that is, those related to the placement of synthetic mesh (e.g. erosion) – should be created with a regional or supra-regional MDT that has the relevant expertise.</p><p>In addition to the general point that complete removal of mesh may not be possible, the committee agreed that it was important that women should be told that there is a risk (albeit uncertain) that bowel symptoms will persist or recur at some (unknown) point in the future after mesh removal and that a temporary or even permanent stoma may be needed after removal surgery for bowel complications.</p><p>Due to the limited evidence for chronic pain management following mesh surgery, the committee made a research recommendation. This is important because, chronic pain and sexual dysfunction after mesh surgery can be debilitating and have a severe impact on a woman’s quality of life. The committee were aware that there was very little evidence to support recommendations about the most appropriate management options for sexual dysfunction after mesh surgery or the most effective management options for women presenting with chronic pain 3 months after mesh surgery. Women are also requesting to have mesh removed in the expectation that it will improve their pain but there is insufficient evidence to guide women and their clinicians on the likelihood of pain improvement or resolution after mesh removal. In order to manage the sexual dysfunction and chronic pain most effectively for this group of patients research needs to be undertaken comparing the different management options currently practised.</p></div></div></div><div id="ch12.s1.4.3"><h4>Cost effectiveness and resource use</h4><p>The committee acknowledged the lack of clinical and economic evidence on the management of vaginal complications, sexual dysfunction and/or pain, urinary complications, bowel complications, and general mesh complications in women with UI, POP or both.</p><p>The committee explained that the recommendations in this area may have resource implications, for example, more MDT reviews and individualised treatment plans, more imaging such as CT or MRI scans, more referrals to specialist centres for assessments, and an increase in the consultation times to explain the risks associated with the removal of mesh. The committee agreed that improving the chances of successfully treating women with mesh-related complications was essential and that these changes are likely to achieve this. The committee explained that timely treatment of these complications may improve outcomes and overall cost savings to the NHS, given that delays in appropriate management may result in worse problems needing more resource intensive management. Also, the committee explained that timely identification and appropriate management of mesh-related complications may reduce the overall burden of symptoms these women experience and have a significant positive impact on their quality of life, especially as some mesh–related complications can last for many years and require expensive long-term management.</p></div><div id="ch12.s1.4.4"><h4>Other factors the committee took into account</h4><p>The committee took into account recommendations from the NICE guideline on <a href="https://www.nice.org.uk/guidance/cg49" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">faecal incontinence</a> which would also be relevant to the treatment of some of the bowel complications women may experience in the context urinary incontinence and they therefore decided to cross refer to it.</p></div></div><div id="ch12.s1.rl.r1"><h3>References</h3><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref1"><p id="p-771">
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<strong>Abbott 2014</strong>
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</p>Abbott, S., Unger, C. A., Evans, J. M., Jallad, K., Mishra, K., Karram, M. M., Iglesia, C. B., Rardin, C. R., Barber, M. D., Evaluation and management of complications from synthetic mesh after pelvic reconstructive surgery: a multicenter study, American Journal of Obstetrics & Gynecology, 210, 163.e1–8, 2014 [<a href="https://pubmed.ncbi.nlm.nih.gov/24126300" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24126300</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref2"><p id="p-772">
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<strong>Begley 2005</strong>
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</p>Begley, J. S., Kupferman, S. P., Kuznetsov, D. D., Kobashi, K. C., Govier, F. E., McGonigle, K. F., Muntz, H. G., Incidence and management of abdominal sacrocolpopexy mesh erosions, American Journal of Obstetrics & Gynecology, 192, 1956–62, 2005 [<a href="https://pubmed.ncbi.nlm.nih.gov/15970860" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15970860</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref3"><p id="p-773">
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<strong>Cardenas-Trowers 2017</strong>
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</p>Cardenas-Trowers, O. O, Malekzadeh, P, Nix, D. E, Hatch, K. D., Vaginal Mesh Removal Outcomes: Eight Years of Experience at an Academic Hospital, Female Pelvic Medicine & Reconstructive Surgery, 20, 20, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28430726" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28430726</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref4"><p id="p-774">
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<strong>Cheng 2017</strong>
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</p>Cheng, Y. W., Su, T. H., Wang, H., Huang, W. C., Lau, H. H., Risk factors and management of vaginal mesh erosion after pelvic organ prolapse surgery, Taiwanese Journal of Obstetrics & Gynecology, 56, 184–187, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28420505" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28420505</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref5"><p id="p-775">
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|
<strong>Crescenze 2016</strong>
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|
</p>Crescenze, I. M., Abraham, N., Li, J., Goldman, H. B., Vasavada, S., Urgency Incontinence before and after Revision of a Synthetic Mid-Urethral Sling, Journal of Urology, 196, 478–483, 2016 [<a href="https://pubmed.ncbi.nlm.nih.gov/26820550" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26820550</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref6"><p id="p-776">
|
|
<strong>Crosby 2014</strong>
|
|
</p>Crosby, E. C, Abernethy, M, Berger, M. B, DeLancey, J. O, Fenner, D. E, Morgan, D. M., Symptom resolution after operative management of complications from transvaginal mesh, Obstetrics & Gynecology, 123, 134–9, 2014 [<a href="/pmc/articles/PMC4055867/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4055867</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24463673" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24463673</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref7"><p id="p-777">
|
|
<strong>Danford 2015</strong>
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|
</p>Danford, J. M., Osborn, D. J., Reynolds, W. S., Biller, D. H., Dmochowski, R. R., Postoperative pain outcomes after transvaginal mesh revision, International urogynecology journal, 26, 65–9, 2015 [<a href="/pmc/articles/PMC4753795/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4753795</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25011703" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25011703</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref8"><p id="p-778">
|
|
<strong>Domingo 2005</strong>
|
|
</p>Domingo, S., Alama, P., Ruiz, N., Perales, A., Pellicer, A., Diagnosis, management and prognosis of vaginal erosion after transobturator suburethral tape procedure using a nonwoven thermally bonded polypropylene mesh, Journal of Urology, 173, 1627–1630, 2005 [<a href="https://pubmed.ncbi.nlm.nih.gov/15821518" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15821518</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref9"><p id="p-779">
|
|
<strong>Fabian 2015</strong>
|
|
</p>Fabian, G, Kociszewski, J, Kuszka, A, Fabian, M, Grothey, S, Zwierzchowska, A, Majkusiak, W, Barcz, E., Vaginal excision of the sub-urethral sling: analysis of indications, safety and outcome, Archives of Medical Science, 11, 982–8, 2015 [<a href="/pmc/articles/PMC4624732/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4624732</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26528340" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26528340</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref10"><p id="p-780">
|
|
<strong>George 2013</strong>
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|
</p>George, A, Mattingly, M, Woodman, P, Hale, D., Recurrence of prolapse after transvaginal mesh excision, Female Pelvic Medicine & Reconstructive Surgery, 19, 202–5, 2013 [<a href="https://pubmed.ncbi.nlm.nih.gov/23797517" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23797517</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref11"><p id="p-781">
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<strong>Hokenstad 2015</strong>
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</p>Hokenstad, E. D, El-Nashar, S. A, Blandon, R. E, Occhino, J. A, Trabuco, E. C, Gebhart, J. B, Klingele, C. J., Health-related quality of life and outcomes after surgical treatment of complications from vaginally placed mesh, Female Pelvic Medicine & Reconstructive Surgery, 21, 176–80, 2015 [<a href="https://pubmed.ncbi.nlm.nih.gov/25349942" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25349942</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref12"><p id="p-782">
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|
<strong>Hou 2014</strong>
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</p>Hou, J. C., Alhalabi, F., Lemack, G. E., Zimmern, P. E., Outcome of transvaginal mesh and tape removed for pain only, The Journal of urology, 192, 856–60, 2014 [<a href="https://pubmed.ncbi.nlm.nih.gov/24735934" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24735934</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref13"><p id="p-783">
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|
<strong>Jambusaria 2016</strong>
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|
</p>Jambusaria, L. H, Heft, J, Reynolds, W. S, Dmochowski, R, Biller, D. H., Incontinence rates after midurethral sling revision for vaginal exposure or pain, American Journal of Obstetrics and Gynecology, 215, 764.e1–764.e5, 2016 [<a href="https://pubmed.ncbi.nlm.nih.gov/27448731" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27448731</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref14"><p id="p-784">
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|
<strong>Jeffery 2012</strong>
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|
</p>Jeffery, S. T, Nieuwoudt, A., Beyond the complications: medium-term anatomical, sexual and functional outcomes following removal of trocar-guided transvaginal mesh. A retrospective cohort study, International Urogynecology Journal, 23, 1391–1396, 2012 [<a href="https://pubmed.ncbi.nlm.nih.gov/22527545" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22527545</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref15"><p id="p-785">
|
|
<strong>Kohli 1998</strong>
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|
</p>Kohli, N., Walsh, P. M., Roat, T. W., Karram, M. M., Mesh erosion after abdominal sacrocolpopexy, Obstetrics and Gynecology, 92, 999–1004, 1998 [<a href="https://pubmed.ncbi.nlm.nih.gov/9840566" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9840566</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref16"><p id="p-786">
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|
<strong>Lee 2013</strong>
|
|
</p>Lee, D, Dillon, B, Lemack, G, Gomelsky, A, Zimmern, P., Transvaginal mesh kits--how serious are the complications and are they reversible?
|
|
Urology, 81, 43–8, 2013 [<a href="https://pubmed.ncbi.nlm.nih.gov/23200966" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23200966</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref17"><p id="p-787">
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|
<strong>Marcus-Braun 2010</strong>
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|
</p>Marcus-Braun, N, von Theobald, P., Mesh removal following transvaginal mesh placement: a case series of 104 operations, International Urogynecology Journal, 21, 423–30, 2010 [<a href="https://pubmed.ncbi.nlm.nih.gov/19936589" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19936589</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref18"><p id="p-788">
|
|
<strong>Misrai 2009</strong>
|
|
</p>Misrai, V, Roupret, M, Xylinas, E, Cour, F, Vaessen, C, Haertig, A, Richard, F, Chartier-Kastler, E., Surgical resection for suburethral sling complications after treatment for stress urinary incontinence, Journal of Urology, 181, 2198–2202, 2009 [<a href="https://pubmed.ncbi.nlm.nih.gov/19296973" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19296973</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref19"><p id="p-789">
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|
<strong>Parden 2016</strong>
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|
</p>Parden, A. M, Tang, Y, Szychowski, J, Richter, H. E., Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision, Journal of Minimally Invasive Gynecology, 23, 979–985, 2016 [<a href="https://pubmed.ncbi.nlm.nih.gov/27393288" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27393288</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref20"><p id="p-790">
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<strong>Pickett 2015</strong>
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</p>Pickett, S. D, Barenberg, B, Quiroz, L. H, Shobeiri, S. A, O’Leary, D. E., The significant morbidity of removing pelvic mesh from multiple vaginal compartments, Obstetrics and Gynecology, 125, 1418–1422, 2015 [<a href="https://pubmed.ncbi.nlm.nih.gov/26000513" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26000513</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref21"><p id="p-791">
|
|
<strong>Rac 2017</strong>
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|
</p>Rac, G, Greiman, A, Rabley, A, Tipton, T. J, Chiles, L. R, Freilich, D. A, Rames, R, Cox, L, Koski, M, Rovner, E. S., Analysis of Complications of Pelvic Mesh Excision Surgery Using the Clavien-Dindo Classification System, Journal of Urology, 19, 19, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28433641" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28433641</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref22"><p id="p-792">
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|
<strong>Ramart 2017</strong>
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|
</p>Ramart, P, Ackerman, A. L, Cohen, S. A, Kim, J. H, Raz, S., The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications, Urology, 106, 203–209, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28476681" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28476681</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref23"><p id="p-793">
|
|
<strong>Renezeder 2011</strong>
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|
</p>Renezeder, K, Skala, C. E, Albrich, S, Koelbl, H, Naumann, G., Complications following the use of alloplastic materials in urogynecological surgery, European Journal of Obstetrics, Gynecology, and Reproductive Biology, 158, 354–357, 2011 [<a href="https://pubmed.ncbi.nlm.nih.gov/21764504" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21764504</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref24"><p id="p-794">
|
|
<strong>Shaw 2017</strong>
|
|
</p>Shaw, J, Wohlrab, K, Rardin, C., Recurrence of stress urinary incontinence after midurethral sling revision: A retrospective cohort study, Female Pelvic Medicine and Reconstructive Surgery, 23, 184–187, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/27748665" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27748665</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref25"><p id="p-795">
|
|
<strong>Skala 2011</strong>
|
|
</p>Skala, C. E, Renezeder, K, Albrich, S, Puhl, A, Laterza, R. M, Naumann, G, Koelbl, H., Mesh complications following prolapse surgery: Management and outcome, European Journal of Obstetrics Gynecology and Reproductive Biology, 159, 453–456, 2011 [<a href="https://pubmed.ncbi.nlm.nih.gov/21824714" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21824714</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="ch12.s1.ref26"><p id="p-796">
|
|
<strong>Warembourg 2017</strong>
|
|
</p>Warembourg, S, Labaki, M, de Tayrac, R, Costa, P, Fatton, B., Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center, International Urogynecology Journal, Jan-13, 2017 [<a href="https://pubmed.ncbi.nlm.nih.gov/28150032" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28150032</span></a>]</div></p></li></ul></div></div><div id="appendixesappgroup12"><h2 id="_appendixesappgroup12_">Appendices</h2><div id="ch12.appa"><h3>Appendix A. Review protocols</h3><div id="ch12.appa.s1"><h4>Review protocol for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><p id="ch12.appa.tab1"><a href="/books/NBK577729/table/ch12.appa.tab1/?report=objectonly" target="object" rid-ob="figobch12appatab1" class="figpopup">Table 20. Review protocol for management options for vaginal complications after mesh surgery</a></p></div><div id="ch12.appa.s2"><h4>Review protocol for review question: What are the most effective management options for sexual dysfunction after mesh surgery?</h4><p id="ch12.appa.tab2"><a href="/books/NBK577729/table/ch12.appa.tab2/?report=objectonly" target="object" rid-ob="figobch12appatab2" class="figpopup">Table 21. Review protocol for management options for sexual dysfunction after mesh surgery</a></p></div><div id="ch12.appa.s3"><h4>Review protocol for review question: What are the most effective management options for pain after mesh surgery?</h4><p id="ch12.appa.tab3"><a href="/books/NBK577729/table/ch12.appa.tab3/?report=objectonly" target="object" rid-ob="figobch12appatab3" class="figpopup">Table 22. Review protocol for management options for pain after mesh surgery</a></p></div><div id="ch12.appa.s4"><h4>Review protocol for review question: What are the most effective management options for urinary complications after mesh surgery?</h4><p id="ch12.appa.tab4"><a href="/books/NBK577729/table/ch12.appa.tab4/?report=objectonly" target="object" rid-ob="figobch12appatab4" class="figpopup">Table 23. Review protocol for management options for urinary complications after mesh surgery</a></p></div><div id="ch12.appa.s5"><h4>Review protocol for review question: What are the most effective management options for bowel symptoms after mesh surgery?</h4><p id="ch12.appa.tab5"><a href="/books/NBK577729/table/ch12.appa.tab5/?report=objectonly" target="object" rid-ob="figobch12appatab5" class="figpopup">Table 24. Review protocol for management options for bowel symptoms after mesh surgery</a></p></div></div><div id="ch12.appb"><h3>Appendix B. Literature search strategies</h3><div id="ch12.appb.s1"><h4>Literature search strategies for review question: Management of vaginal complications and/or pain complications after mesh or mesh sling surgery</h4><p>
|
|
<b>Database: Medline & Embase (Multifile)</b>
|
|
</p><p>
|
|
<b>Last searched on Embase Classic+Embase 1947 to 2017 November 29, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present.</b>
|
|
</p><p>
|
|
<b>Date of last search: 29<sup>th</sup> November 2017.</b>
|
|
</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab1"><a href="/books/NBK577729/table/ch12.appb.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab1" rid-ob="figobch12appbtab1"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab1/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab1/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab1"><a href="/books/NBK577729/table/ch12.appb.tab1/?report=objectonly" target="object" rid-ob="figobch12appbtab1">Table</a></h4></div></div><p>
|
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<b>Database: Cochrane Library via Wiley Online</b>
|
|
</p><p>
|
|
<b>Date of last search: 29<sup>th</sup> November 2017.</b>
|
|
</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab2"><a href="/books/NBK577729/table/ch12.appb.tab2/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab2" rid-ob="figobch12appbtab2"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab2/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab2/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab2"><a href="/books/NBK577729/table/ch12.appb.tab2/?report=objectonly" target="object" rid-ob="figobch12appbtab2">Table</a></h4></div></div></div><div id="ch12.appb.s2"><h4>Literature search strategy for review question: Management of sexual dysfunction and/or pain complications after mesh or mesh sling surgery</h4><p>
|
|
<b>Database: Medline & Embase (Multifile)</b>
|
|
</p><p>
|
|
<b>Last searched on Embase Classic+Embase 1947 to 2017 November 20, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present.</b>
|
|
</p><p>
|
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<b>Date of last search: 20<sup>th</sup> November 2017.</b>
|
|
</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab3"><a href="/books/NBK577729/table/ch12.appb.tab3/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab3" rid-ob="figobch12appbtab3"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab3/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab3/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab3"><a href="/books/NBK577729/table/ch12.appb.tab3/?report=objectonly" target="object" rid-ob="figobch12appbtab3">Table</a></h4></div></div><p>
|
|
<b>Database: Cochrane Library via Wiley Online</b>
|
|
</p><p>
|
|
<b>Date of last search: 20<sup>th</sup> November 2017.</b>
|
|
</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab4"><a href="/books/NBK577729/table/ch12.appb.tab4/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab4" rid-ob="figobch12appbtab4"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab4/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab4/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab4"><a href="/books/NBK577729/table/ch12.appb.tab4/?report=objectonly" target="object" rid-ob="figobch12appbtab4">Table</a></h4></div></div></div><div id="ch12.appb.s3"><h4>Literature search strategy for review question: Management of urinary complications after mesh or mesh sling surgery</h4><p>
|
|
<b>Database: Medline & Embase (Multifile)</b>
|
|
</p><p>
|
|
<b>Last searched on Embase Classic+Embase 1947 to 2017 September 19, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present.</b>
|
|
</p><p>
|
|
<b>Date of last search: 20<sup>th</sup> September 2017.</b>
|
|
</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab5"><a href="/books/NBK577729/table/ch12.appb.tab5/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab5" rid-ob="figobch12appbtab5"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab5/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab5/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab5"><a href="/books/NBK577729/table/ch12.appb.tab5/?report=objectonly" target="object" rid-ob="figobch12appbtab5">Table</a></h4></div></div><p>
|
|
<b>Database: Cochrane Library via Wiley Online</b>
|
|
</p><p>
|
|
<b>Date of last search: 20<sup>th</sup> September 2017.</b>
|
|
</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab6"><a href="/books/NBK577729/table/ch12.appb.tab6/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab6" rid-ob="figobch12appbtab6"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab6/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab6/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab6"><a href="/books/NBK577729/table/ch12.appb.tab6/?report=objectonly" target="object" rid-ob="figobch12appbtab6">Table</a></h4></div></div></div><div id="ch12.appb.s4"><h4>Literature search strategy for review question: Management of bowel complications after mesh or mesh sling surgery</h4><p>
|
|
<b>Database: Medline & Embase (Multifile)</b>
|
|
</p><p>
|
|
<b>Last searched on Embase Classic+Embase 1947 to 2018 March 23, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1946 to Present.</b>
|
|
</p><p>
|
|
<b>Date of last search: 26<sup>th</sup> March 2018.</b>
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</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab7"><a href="/books/NBK577729/table/ch12.appb.tab7/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab7" rid-ob="figobch12appbtab7"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab7/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab7/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab7"><a href="/books/NBK577729/table/ch12.appb.tab7/?report=objectonly" target="object" rid-ob="figobch12appbtab7">Table</a></h4></div></div><p>
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<b>Database: Cochrane Library via Wiley Online</b>
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</p><p>
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<b>Date of last search: 26<sup>th</sup> March 2018.</b>
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</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch12appbtab8"><a href="/books/NBK577729/table/ch12.appb.tab8/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figch12appbtab8" rid-ob="figobch12appbtab8"><img class="small-thumb" src="/books/NBK577729/table/ch12.appb.tab8/?report=thumb" src-large="/books/NBK577729/table/ch12.appb.tab8/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="ch12.appb.tab8"><a href="/books/NBK577729/table/ch12.appb.tab8/?report=objectonly" target="object" rid-ob="figobch12appbtab8">Table</a></h4></div></div></div></div><div id="ch12.appc"><h3>Appendix C. Clinical evidence study selection</h3><div id="ch12.appc.s1"><h4>Clinical evidence study selection for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><p id="ch12.appc.fig1"><a href="/books/NBK577729/figure/ch12.appc.fig1/?report=objectonly" target="object" rid-ob="figobch12appcfig1" class="figpopup">Figure 1. PRISMA flow diagram for review of management of vaginal complications after mesh or mesh sling surgery</a></p></div><div id="ch12.appc.s2"><h4>Clinical evidence study selection for review question: What are the most effective management options for sexual dysfunction and/or pain complications after mesh or mesh sling surgery</h4><p id="ch12.appc.fig2"><a href="/books/NBK577729/figure/ch12.appc.fig2/?report=objectonly" target="object" rid-ob="figobch12appcfig2" class="figpopup">Figure 2. PRISMA flow diagram for review on management of sexual dysfunction and/or pain complications after mesh or mesh sling surgery</a></p></div><div id="ch12.appc.s3"><h4>Clinical evidence study selection for review question: What are the most effective management options for urinary complications after mesh or mesh sling surgery</h4><p id="ch12.appc.fig3"><a href="/books/NBK577729/figure/ch12.appc.fig3/?report=objectonly" target="object" rid-ob="figobch12appcfig3" class="figpopup">Figure 3. PRISMA flow diagram for review on management of urinary complications after mesh or mesh sling surgery</a></p></div><div id="ch12.appc.s4"><h4>Clinical evidence study selection for review question: What are the most effective management options for bowel complications after mesh surgery?</h4><p id="ch12.appc.fig4"><a href="/books/NBK577729/figure/ch12.appc.fig4/?report=objectonly" target="object" rid-ob="figobch12appcfig4" class="figpopup">Figure 4. PRISMA flow diagram for review on management of bowel complications after mesh or mesh sling surgery</a></p></div></div><div id="ch12.appd"><h3>Appendix D. Clinical evidence tables</h3><div id="ch12.appd.s1"><h4>Clinical evidence tables for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><p id="ch12.appd.et1"><a href="/books/NBK577729/bin/ch12-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 25. Clinical evidence tables for management options for vaginal complications after mesh surgery</a><span class="small"> (PDF, 245K)</span></p></div><div id="ch12.appd.s2"><h4>Clinical evidence tables for review question: What are the most effective management options for sexual dysfunction after mesh surgery?</h4><p id="ch12.appd.et2"><a href="/books/NBK577729/bin/ch12-appd-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 26. Clinical evidence tables for management options for sexual dysfunction after mesh surgery</a><span class="small"> (PDF, 216K)</span></p></div><div id="ch12.appd.s3"><h4>Clinical evidence tables for evidence review: What are the most effective management options for urinary complications after mesh surgery?</h4><p id="ch12.appd.et3"><a href="/books/NBK577729/bin/ch12-appd-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 27. Clinical evidence tables for management options for pain after mesh surgery</a><span class="small"> (PDF, 168K)</span></p></div><div id="ch12.appd.s4"><h4>Clinical evidence tables for evidence review: What are the most effective management options for urinary complications after mesh surgery?</h4><p id="ch12.appd.et4"><a href="/books/NBK577729/bin/ch12-appd-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 28. Clinical evidence table for general management of mesh complications after mesh or mesh sling surgery</a><span class="small"> (PDF, 475K)</span></p></div><div id="ch12.appd.s5"><h4>Clinical evidence tables for evidence review: What are the most effective management options for bowel symptoms after mesh surgery?</h4><p>There were no studies identified for this review, therefore there are no evidence tables for this review question.</p></div></div><div id="ch12.appe"><h3>Appendix E. Forest plots</h3><div id="ch12.appe.s1"><h4>Forest plots for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><div id="ch12.appe.s1.1"><h5>Partial mesh removal versus complete mesh removal</h5><p id="ch12.appe.fig1"><a href="/books/NBK577729/figure/ch12.appe.fig1/?report=objectonly" target="object" rid-ob="figobch12appefig1" class="figpopup">Figure 7. Recurrent SUI at 12-mo follow up</a></p></div></div><div id="ch12.appe.s2"><h4>Forest plots for review question: what are the most effective management options for sexual dysfunction and/or pain complications after mesh or mesh sling surgery?</h4><p>It was not possible to conduct meta-analysis as no comparative studies were identified for this review question. Therefore no forest plots are included in this appendix.</p></div><div id="ch12.appe.s3"><h4>Forest plots for review question: what are the most effective management options for urinary complications after mesh or mesh sling surgery</h4><p>It was not possible to conduct meta-analysis as no comparative studies were identified for this review question. Therefore no forest plots are included in this appendix.</p></div><div id="ch12.appe.s4"><h4>Forest plots for review question: What are the most effective management options for bowel complications after mesh or mesh sling surgery</h4><p>No comparative studies were identified for this review question. Therefore no forest plots are included in this appendix.</p></div><div id="ch12.appe.s5"><h4>General management of mesh complications after mesh or mesh sling surgery</h4><p>It was not possible to conduct meta-analysis as only 1 comparative cohort study was identified for this review. Therefore no forest plots are included in this appendix.</p></div></div><div id="ch12.appf"><h3>Appendix F. GRADE tables</h3><p>Full GRADE tables for the comparisons examined appear below.</p><p>Note that the GRADE tables for the review questions on the management of sexual dysfunction and the management of pain are combined as the relevant studies did not allow a delineation of outcomes for each mesh complication.</p><p>Full GRADE tables for the comparisons examined in the section on the general management of mesh complications, for which there is no protocol, are also available</p><div id="ch12.appf.s1"><h4>GRADE tables for review question: What are the most effective management options for vaginal complications after mesh surgery?</h4><p id="ch12.appf.tab1"><a href="/books/NBK577729/table/ch12.appf.tab1/?report=objectonly" target="object" rid-ob="figobch12appftab1" class="figpopup">Table 29. Evidence profile for partial mesh sling removal versus complete mesh sling removal in women with vaginal complications</a></p></div><div id="ch12.appf.s2"><h4>GRADE tables for review question: What are the most effective management options for sexual dysfunction after mesh surgery? And GRADE tables for review question: What are the most effective management options for pain after mesh surgery?</h4><p id="ch12.appf.tab2"><a href="/books/NBK577729/table/ch12.appf.tab2/?report=objectonly" target="object" rid-ob="figobch12appftab2" class="figpopup">Table 30. Clinical evidence profile for partial mesh sling removal versus complete mesh sling removal in women with sexual dysfunction and/or pain complications</a></p><p id="ch12.appf.tab3"><a href="/books/NBK577729/table/ch12.appf.tab3/?report=objectonly" target="object" rid-ob="figobch12appftab3" class="figpopup">Table 31. Clinical evidence profile for mesh removal versus mesh sling removal in women with sexual dysfunction and/or pain complications</a></p></div><div id="ch12.appf.s3"><h4>GRADE tables for review question: What are the most effective management options for urinary complications after mesh surgery?</h4><p>No studies were identified which were applicable to this review question.</p></div><div id="ch12.appf.s4"><h4>GRADE tables for review question: What are the most effective management options for bowel symptoms after mesh surgery?</h4><p>No studies were identified which were applicable to this review question.</p></div><div id="ch12.appf.s5"><h4>GRADE tables for general management of mesh complications after mesh or mesh sling surgery</h4><p id="ch12.appf.tab4"><a href="/books/NBK577729/table/ch12.appf.tab4/?report=objectonly" target="object" rid-ob="figobch12appftab4" class="figpopup">Table 32. Clinical evidence profile for partial mesh removal versus complete mesh removal in women with mesh complications</a></p><p id="ch12.appf.tab5"><a href="/books/NBK577729/table/ch12.appf.tab5/?report=objectonly" target="object" rid-ob="figobch12appftab5" class="figpopup">Table 33. Clinical evidence profile for mesh division versus mesh removal in women with mesh complications</a></p><p id="ch12.appf.tab6"><a href="/books/NBK577729/table/ch12.appf.tab6/?report=objectonly" target="object" rid-ob="figobch12appftab6" class="figpopup">Table 34. Clinical evidence profile for transobturator mesh sling removal versus retropubic mesh sling removal in women with mesh complications</a></p></div></div><div id="ch12.appg"><h3>Appendix G. Economic evidence study selection</h3><div id="ch12.appg.s1"><h4>Economic evidence study selection for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><p>One global search was conducted for this review question. See supplementary material D for further information.</p></div><div id="ch12.appg.s2"><h4>Economic evidence study selection for review question: What are the most effective management options for sexual dysfunction after mesh surgery?</h4><p>One global search was conducted for this review question. See supplementary material D for further information.</p></div><div id="ch12.appg.s3"><h4>Economic evidence study selection for review question: What are the most effective management options for pain after mesh surgery?</h4><p>One global search was conducted for this review question. See supplementary material D for further information.</p></div><div id="ch12.appg.s4"><h4>Economic evidence study selection for review question: What are the most effective management options for urinary complications after mesh surgery?</h4><p>One global search was conducted for this review question. See supplementary material D for further information.</p></div><div id="ch12.appg.s5"><h4>Economic evidence study selection for review question: What are the most effective management options for bowel symptoms after mesh surgery?</h4><p>One global search was conducted for this review question. See supplementary material D for further information.</p></div></div><div id="ch12.apph"><h3>Appendix H. Economic evidence tables</h3><div id="ch12.apph.s1"><h4>Economic evidence tables for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.apph.s2"><h4>Economic evidence tables for review question: What are the most effective management options for sexual dysfunction after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.apph.s3"><h4>Economic evidence tables for review question: What are the most effective management options for pain after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.apph.s4"><h4>Economic evidence tables for review question: What are the most effective management options for urinary complications after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.apph.s5"><h4>Economic evidence tables for review question: What are the most effective management options for bowel symptoms after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div></div><div id="ch12.appi"><h3>Appendix I. Economic evidence profiles</h3><div id="ch12.appi.s1"><h4>Economic evidence profiles for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.appi.s2"><h4>Economic evidence profiles for review question: What are the most effective management options for sexual dysfunction after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.appi.s3"><h4>Economic evidence profiles for review question: What are the most effective management options for pain after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.appi.s4"><h4>Economic evidence profiles for review question: What are the most effective management options for urinary complications after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div><div id="ch12.appi.s5"><h4>Economic evidence profiles for review question: What are the most effective management options for bowel symptoms after mesh surgery?</h4><p>No economic evidence was identified which was applicable to this review question.</p></div></div><div id="ch12.appj"><h3>Appendix J. Economic analysis</h3><div id="ch12.appj.s1"><h4>Economic analysis for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><p>No economic analysis was conducted for this review question.</p></div><div id="ch12.appj.s2"><h4>Economic analysis for review question: What are the most effective management options for sexual dysfunction after mesh surgery?</h4><p>No economic analysis was conducted for this review question.</p></div><div id="ch12.appj.s3"><h4>Economic analysis for review question: What are the most effective management options for pain after mesh surgery?</h4><p>No economic analysis was conducted for this review question.</p></div><div id="ch12.appj.s4"><h4>Economic analysis for review question: What are the most effective management options for urinary complications after mesh surgery?</h4><p>No economic analysis was conducted for this review question.</p></div><div id="ch12.appj.s5"><h4>Economic analysis for review question: What are the most effective management options for bowel symptoms after mesh surgery?</h4><p>No economic analysis was conducted for this review question.</p></div></div><div id="ch12.appk"><h3>Appendix K. Excluded studies</h3><div id="ch12.appk.s1"><h4>Excluded studies for review question: What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</h4><div id="ch12.appk.s1.1"><h5>Clinical studies</h5><p id="ch12.appk.tab1"><a href="/books/NBK577729/table/ch12.appk.tab1/?report=objectonly" target="object" rid-ob="figobch12appktab1" class="figpopup">Table 35. Excluded clinical studies with reasons for exclusion</a></p></div><div id="ch12.appk.s1.2"><h5>Economic studies</h5><p>No economic evidence was identified for this review. See supplementary material D for further information.</p></div></div><div id="ch12.appk.s2"><h4>Excluded studies for review question: What are the most effective management options for sexual dysfunction after mesh surgery? And excluded studies for review question: What are the most effective management options for pain after mesh surgery?</h4><div id="ch12.appk.s2.1"><h5>Clinical studies</h5><p id="ch12.appk.tab2"><a href="/books/NBK577729/table/ch12.appk.tab2/?report=objectonly" target="object" rid-ob="figobch12appktab2" class="figpopup">Table 36. Excluded studies with reasons for exclusion</a></p></div><div id="ch12.appk.s2.2"><h5>Economic studies</h5><p>No economic evidence was identified for this review. See supplementary material D for further information.</p></div></div><div id="ch12.appk.s3"><h4>Excluded studies for review question: What are the most effective management options for urinary complications after mesh surgery?</h4><div id="ch12.appk.s3.1"><h5>Clinical studies</h5><p id="ch12.appk.tab3"><a href="/books/NBK577729/table/ch12.appk.tab3/?report=objectonly" target="object" rid-ob="figobch12appktab3" class="figpopup">Table 37. Excluded clinical studies with reasons for exclusion</a></p></div><div id="ch12.appk.s3.2"><h5>Economic studies</h5><p>No economic evidence was identified for this review. See supplementary material D for further information.</p></div></div><div id="ch12.appk.s4"><h4>Excluded studies for review question: What are the most effective management options for bowel symptoms after mesh surgery?</h4><div id="ch12.appk.s4.1"><h5>Clinical studies</h5><p id="ch12.appk.tab4"><a href="/books/NBK577729/table/ch12.appk.tab4/?report=objectonly" target="object" rid-ob="figobch12appktab4" class="figpopup">Table 38. Excluded clinical studies with reasons for exclusion</a></p></div><div id="ch12.appk.s4.2"><h5>Economic studies</h5><p>No economic evidence was identified for this review. See supplementary material D for further information.</p></div></div><div id="ch12.appk.s5"><h4>General management of mesh complications after mesh or mesh sling surgery</h4><p>See list of excluded studies for individual complications reviews.</p></div></div><div id="ch12.appl"><h3>Appendix L. Research recommendations</h3><div id="ch12.appl.s1"><h4>Research recommendations for the review questions</h4><ul id="ch12.l161"><li id="ch12.lt583" class="half_rhythm"><div>What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</div></li><li id="ch12.lt584" class="half_rhythm"><div>What are the most effective management options for sexual dysfunction after mesh surgery?</div></li><li id="ch12.lt585" class="half_rhythm"><div>What are the most effective management options for pain after mesh surgery?</div></li><li id="ch12.lt586" class="half_rhythm"><div>What are the most effective management options for urinary complications after mesh surgery?</div></li><li id="ch12.lt587" class="half_rhythm"><div>What are the most effective management options for bowel symptoms after mesh surgery?</div></li></ul><p>What is the effectiveness of pain management for women who present with chronic pain 3 months after mesh surgery for stress urinary incontinence or pelvic organ prolapse?</p><p>
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<b>Why is this important?</b>
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</p><p>Chronic pain and sexual dysfunction after mesh surgery can be debilitating and have a severe impact on a woman’s quality of life. The committee was aware that there was very little evidence to support recommendations about the most appropriate management options for sexual dysfunction after mesh surgery or the most effective management options for women presenting with chronic pain 3 months after mesh surgery. Women are also requesting to have mesh removed in the expectation that it will improve their pain but there is insufficient evidence to guide women and their clinicians on the likelihood of pain improvement or resolution after mesh removal. In order to manage the sexual dysfunction and chronic pain most effectively for this group of patients research needs to be undertaken comparing the different management options currently practised.</p><p id="ch12.appl.tab1"><a href="/books/NBK577729/table/ch12.appl.tab1/?report=objectonly" target="object" rid-ob="figobch12appltab1" class="figpopup">Table 39. Research recommendation rationale</a></p><p id="ch12.appl.tab2"><a href="/books/NBK577729/table/ch12.appl.tab2/?report=objectonly" target="object" rid-ob="figobch12appltab2" class="figpopup">Table 40. Research recommendation modified PICO table v1</a></p><p id="ch12.appl.tab3"><a href="/books/NBK577729/table/ch12.appl.tab3/?report=objectonly" target="object" rid-ob="figobch12appltab3" class="figpopup">Table 41. Research recommendation modified PICO table v2 (deprioritised)</a></p><p id="ch12.appl.tab4"><a href="/books/NBK577729/table/ch12.appl.tab4/?report=objectonly" target="object" rid-ob="figobch12appltab4" class="figpopup">Table 42. Research recommendation modified PICO table v3 (deprioritised)</a></p><p id="ch12.appl.tab5"><a href="/books/NBK577729/table/ch12.appl.tab5/?report=objectonly" target="object" rid-ob="figobch12appltab5" class="figpopup">Table 43. Research recommendation modified PICO table v4 (deprioritised)</a></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews</p><p>These evidence reviews were developed by the National Guideline Alliance hosted by the Royal College of Obstetricians and Gynaecologists</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2019.</div><div class="small"><span class="label">Bookshelf ID: NBK577729</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35138781" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35138781</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobch12tab1"><div id="ch12.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of protocol (PICO table) for management of vaginal complications after mesh or mesh sling surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab1_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_ch12.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch12.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Women (aged 18 years and over) who are experiencing vaginal complications after mesh surgery (both biological and synthetic materials) for UI, POP or both.</p>
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<p>Women presenting the following complications will be included:
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<ul id="ch12.l2"><li id="ch12.lt6" class="half_rhythm"><div>Mesh erosion (including exposure and extrusion)</div></li><li id="ch12.lt7" class="half_rhythm"><div>Mesh infection</div></li></ul></p></td></tr><tr><th id="hd_b_ch12.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_ch12.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The following management options will be considered:
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<ul id="ch12.l3"><li id="ch12.lt8" class="half_rhythm"><div>Mesh removal surgery (vaginal removal or trimming of mesh, abdominal/laparoscopic removal of mesh)</div></li><li id="ch12.lt9" class="half_rhythm"><div>Partial or complete mesh removal</div></li><li id="ch12.lt10" class="half_rhythm"><div>Vaginal oestrogen</div></li><li id="ch12.lt11" class="half_rhythm"><div>Antibiotics, systemic or local</div></li><li id="ch12.lt12" class="half_rhythm"><div>Drainage/collection of pus</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_ch12.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l4"><li id="ch12.lt13" class="half_rhythm"><div>Mesh removal surgery <i>vs</i>. no surgery</div></li><li id="ch12.lt14" class="half_rhythm"><div>Mesh removal surgery <i>vs</i>. vaginal oestrogen</div></li><li id="ch12.lt15" class="half_rhythm"><div>Mesh removal surgery <i>vs</i>. antibiotics</div></li><li id="ch12.lt16" class="half_rhythm"><div>Vaginal oestrogen <i>vs</i>. no treatment</div></li><li id="ch12.lt17" class="half_rhythm"><div>Partial removal of mesh <i>vs</i>. complete removal</div></li><li id="ch12.lt18" class="half_rhythm"><div>Drainage/collection of pus <i>vs</i>. no treatment</div></li><li id="ch12.lt19" class="half_rhythm"><div>Drainage/collection of pus <i>vs</i>. antibiotics</div></li><li id="ch12.lt20" class="half_rhythm"><div>Drainage/collection of pus <i>vs</i>. removal of mesh</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch12.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul id="ch12.l5"><li id="ch12.lt21" class="half_rhythm"><div>Continued or repeated exposure/extrusion/infection</div></li><li id="ch12.lt22" class="half_rhythm"><div>Adverse events (immediate post-op or perioperative):
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<ul id="ch12.l6" class="circle"><li id="ch12.lt23" class="half_rhythm"><div>Severe bleeding requiring a blood transfusion</div></li><li id="ch12.lt24" class="half_rhythm"><div>Internal organ injury (to bladder or bowel)</div></li></ul></div></li><li id="ch12.lt25" class="half_rhythm"><div>Long-term complications (> 12 months)
|
|
<ul id="ch12.l7" class="circle"><li id="ch12.lt26" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt27" class="half_rhythm"><div>Mesh erosion or extrusion</div></li><li id="ch12.lt28" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt29" class="half_rhythm"><div>Need for catheterisation</div></li><li id="ch12.lt30" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt31" class="half_rhythm"><div>De novo overactive bladder symptoms</div></li><li id="ch12.lt32" class="half_rhythm"><div>Sexual dysfunction</div></li><li id="ch12.lt33" class="half_rhythm"><div>Wound complications (infection and tissue breakdown)</div></li></ul></div></li></ul>
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<b>Important</b>
|
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<ul id="ch12.l8"><li id="ch12.lt34" class="half_rhythm"><div>Health-related quality of life (validated scales only)</div></li><li id="ch12.lt35" class="half_rhythm"><div>Patient satisfaction
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<ul id="ch12.l9" class="circle"><li id="ch12.lt36" class="half_rhythm"><div>Patient reported improvement</div></li><li id="ch12.lt37" class="half_rhythm"><div>Patient Global Impression of Improvement</div></li></ul></div></li><li id="ch12.lt38" class="half_rhythm"><div>Repeat surgery (for mesh complications)</div></li><li id="ch12.lt39" class="half_rhythm"><div>Recurrence of urinary incontinence or prolapse</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">POP, pelvic organ prolapse; UI, urinary incontinence.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab2"><div id="ch12.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of protocol (PICO table) for management of sexual dysfunction complications after mesh or mesh sling surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab2_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_ch12.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch12.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women over 18 years of age experiencing new or worsening sexual dysfunction after mesh surgery for UI, POP or both.</td></tr><tr><th id="hd_b_ch12.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_ch12.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul id="ch12.l10"><li id="ch12.lt40" class="half_rhythm"><div>Mesh removal surgery</div></li><li id="ch12.lt41" class="half_rhythm"><div>Vaginal dilation</div></li><li id="ch12.lt42" class="half_rhythm"><div>Vaginal reconstruction/vaginaplasty</div></li><li id="ch12.lt43" class="half_rhythm"><div>Vaginal oestrogen</div></li><li id="ch12.lt44" class="half_rhythm"><div>Pain management for dyspareunia (including psychosexual counselling, local anaesthetic, physiotherapy, systemic analgesics, botulinum toxin)</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_ch12.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l11"><li id="ch12.lt45" class="half_rhythm"><div>Vaginal oestrogen <i>vs</i>. mesh removal surgery</div></li><li id="ch12.lt46" class="half_rhythm"><div>Any intervention <i>vs</i>. no treatment</div></li><li id="ch12.lt47" class="half_rhythm"><div>Any surgery <i>vs</i>. pain management</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab2_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch12.tab2_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
|
|
<ul id="ch12.l12"><li id="ch12.lt48" class="half_rhythm"><div>Continued or repeat sexual dysfunction</div></li><li id="ch12.lt49" class="half_rhythm"><div>Adverse events (severe bleeding, unintentional organ injury)</div></li><li id="ch12.lt50" class="half_rhythm"><div>Patient satisfaction (patient reported improvement, Patient Global Impression of Improvement)</div></li></ul>
|
|
<b>Important</b>
|
|
<ul id="ch12.l13"><li id="ch12.lt51" class="half_rhythm"><div>Health-related quality of life</div></li><li id="ch12.lt52" class="half_rhythm"><div>Repeat surgery for UI, POP, or mesh complications</div></li><li id="ch12.lt53" class="half_rhythm"><div>Long-term complications (pain, fistula, need for catheterisation, infection, wound complication)</div></li><li id="ch12.lt54" class="half_rhythm"><div>Partner satisfaction</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">POP, pelvic organ prolapse; UI, urinary incontinence.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab3"><div id="ch12.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary of protocol (PICO table) for management of pain complications after mesh or mesh sling surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab3_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_ch12.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch12.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women over 18 years of age experiencing pain after mesh surgery.</td></tr><tr><th id="hd_b_ch12.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_ch12.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul id="ch12.l14"><li id="ch12.lt55" class="half_rhythm"><div>Mesh removal (partial or complete) surgery</div></li><li id="ch12.lt56" class="half_rhythm"><div>Vaginal oestrogen</div></li><li id="ch12.lt57" class="half_rhythm"><div>Systemic or local antibiotics</div></li><li id="ch12.lt58" class="half_rhythm"><div>Pus collection or drainage</div></li><li id="ch12.lt59" class="half_rhythm"><div>Pain management (including local anaesthetic, physiotherapy, systemic analgesic, botulinum toxin)</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_ch12.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
<ul id="ch12.l15"><li id="ch12.lt60" class="half_rhythm"><div>Vaginal oestrogen <i>vs</i>. mesh removal surgery</div></li><li id="ch12.lt61" class="half_rhythm"><div>Any intervention <i>vs</i>. no treatment</div></li><li id="ch12.lt62" class="half_rhythm"><div>Any surgery <i>vs</i>. pain management</div></li><li id="ch12.lt63" class="half_rhythm"><div>Pus collection/drainage <i>vs</i>. antibiotics</div></li><li id="ch12.lt64" class="half_rhythm"><div>Pus collection/drainage <i>vs</i>. mesh removal surgery</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch12.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
|
|
<ul id="ch12.l16"><li id="ch12.lt65" class="half_rhythm"><div>Pain (using validated scale)</div></li><li id="ch12.lt66" class="half_rhythm"><div>Patient satisfaction (patient-reported improvement, Patient Global Impression of Improvement)</div></li><li id="ch12.lt67" class="half_rhythm"><div>Adverse events (severe bleeding, unintentional organ injury)</div></li><li id="ch12.lt68" class="half_rhythm"><div>Health-related quality of life</div></li></ul>
|
|
<b>Important</b>
|
|
<ul id="ch12.l17"><li id="ch12.lt69" class="half_rhythm"><div>Repeat surgery for UI, POP, or mesh complications)</div></li><li id="ch12.lt70" class="half_rhythm"><div>Long-term complications (pain, fistula, need for catheterisation, infection, wound complications, de novo OAB symptoms, sexual dysfunction)</div></li><li id="ch12.lt71" class="half_rhythm"><div>Recurrence of UI or POP</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">OAB, overactive bladder; POP, pelvic organ prolapse; UI, urinary incontinence.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab4"><div id="ch12.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Summary of protocol (PICO table) for management of urinary complications after mesh or mesh sling surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab4_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_ch12.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch12.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women over 18 years of age experiencing urinary complications after mesh surgery.</td></tr><tr><th id="hd_b_ch12.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_ch12.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul id="ch12.l18"><li id="ch12.lt72" class="half_rhythm"><div>Mesh removal surgery</div></li><li id="ch12.lt73" class="half_rhythm"><div>Transurethral excision</div></li><li id="ch12.lt74" class="half_rhythm"><div>Vaginal approach to mesh excision</div></li><li id="ch12.lt75" class="half_rhythm"><div>Division of tape/mesh</div></li></ul>
|
|
Subgroups
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|
<ul id="ch12.l19"><li id="ch12.lt76" class="half_rhythm"><div>Type of surgical approach (e.g. laparoscopy/open)</div></li><li id="ch12.lt77" class="half_rhythm"><div>Complete versus partial</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_ch12.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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|
<ul id="ch12.l20"><li id="ch12.lt78" class="half_rhythm"><div>Mesh removal <i>vs</i>. no mesh removal</div></li><li id="ch12.lt79" class="half_rhythm"><div>Excision <i>vs</i>. vaginal open excision</div></li><li id="ch12.lt80" class="half_rhythm"><div>Laser <i>vs</i>. open excision</div></li><li id="ch12.lt81" class="half_rhythm"><div>Laser <i>vs</i>. abdominal removal</div></li><li id="ch12.lt82" class="half_rhythm"><div>Mesh division <i>vs</i>. no surgery</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab4_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch12.tab4_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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|
<ul id="ch12.l21"><li id="ch12.lt83" class="half_rhythm"><div>Continued or repeated urinary complications</div></li><li id="ch12.lt84" class="half_rhythm"><div>Adverse events
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<ul id="ch12.l22" class="circle"><li id="ch12.lt85" class="half_rhythm"><div>Severe bleeding requiring blood transfusion</div></li><li id="ch12.lt86" class="half_rhythm"><div>Unintentional organ injury</div></li></ul></div></li><li id="ch12.lt87" class="half_rhythm"><div>Long-term complications
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<ul id="ch12.l23" class="circle"><li id="ch12.lt88" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt89" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt90" class="half_rhythm"><div>Need for catheterisation</div></li><li id="ch12.lt91" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt92" class="half_rhythm"><div>Wound complications</div></li><li id="ch12.lt93" class="half_rhythm"><div>Urinary incontinence</div></li></ul></div></li></ul>
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<b>Important</b>
|
|
<ul id="ch12.l24"><li id="ch12.lt94" class="half_rhythm"><div>Quality of life
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|
<ul id="ch12.l25" class="circle"><li id="ch12.lt95" class="half_rhythm"><div>ICIQ-VS</div></li><li id="ch12.lt96" class="half_rhythm"><div>EPAQ</div></li><li id="ch12.lt97" class="half_rhythm"><div>PFIQ-7/PFDI-21</div></li><li id="ch12.lt98" class="half_rhythm"><div>BFLUTS</div></li><li id="ch12.lt99" class="half_rhythm"><div>i-QOL</div></li><li id="ch12.lt100" class="half_rhythm"><div>SUIQQ</div></li><li id="ch12.lt101" class="half_rhythm"><div>UISS</div></li><li id="ch12.lt102" class="half_rhythm"><div>SEAPI-QMM</div></li><li id="ch12.lt103" class="half_rhythm"><div>ISI</div></li><li id="ch12.lt104" class="half_rhythm"><div>KHQ</div></li></ul></div></li><li id="ch12.lt105" class="half_rhythm"><div>Patient satisfaction (measured by PFDI, patient reported)</div></li><li id="ch12.lt106" class="half_rhythm"><div>Repeat surgery for UI, POP, or mesh complications)</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">BFLUTS-SF, Bristol Lower Urinary Tract Symptoms Scored Form EPAQ, Electronic Patient Assessment Questionnaire-Pelvic Floor; ICIQ-VS: International Consultation on Incontinence Modular Questionnaire – Vaginal Symptoms; i-QoL, Urinary Incontinence Quality of Life Scale; ISI, Incontinence Severity Index; KHQ, King’s Health Questionnaire; PFIQ-7/PFDI-21, Pelvic Floor Distress Inventory Short Form/Long Form; POP, pelvic organ prolapse; SEAPI-QMM, Stress, Emptying Ability, Anatomy, Protection, Inhibition of bladder activity-Quality of life, Mobility, Mental status standardised reporting system; SUIIQQ, Stress and Urgency Incontinence and Quality of Life Questionnaire UI, urinary incontinence; UISS, Urinary Incontinence Severity Score.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab5"><div id="ch12.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Summary of protocol (PICO table) for management of bowel complications after mesh or mesh sling surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab5_lrgtbl__"><table class="no_bottom_margin"><tbody><tr><th id="hd_b_ch12.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch12.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l26" class="simple-list"><li id="ch12.lt107" class="half_rhythm"><div>Women (aged 18 years or older) experiencing bowel complications after mesh surgery for UI, POP or both.</div></li><li id="ch12.lt108" class="half_rhythm"><div>Both functional complications (directly related to bowel action) and non-functional complications (not directly related to action of bowel, but occurring in the location of the bowel) will be included.</div></li><li id="ch12.lt109" class="half_rhythm"><div>Women with any of the following bowel complications will be considered:
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<ul id="ch12.l27"><li id="ch12.lt110" class="half_rhythm"><div>Non-functional
|
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<ul id="ch12.l28" class="circle"><li id="ch12.lt111" class="half_rhythm"><div>Mesh erosion presented as: fever, malaise, pelvic pain, mucous or bloody discharge per rectum</div></li><li id="ch12.lt112" class="half_rhythm"><div>Bowel stricture</div></li><li id="ch12.lt113" class="half_rhythm"><div>Bowel fistulation</div></li></ul></div></li><li id="ch12.lt114" class="half_rhythm"><div>Functional
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<ul id="ch12.l29" class="circle"><li id="ch12.lt115" class="half_rhythm"><div>Obstructed defecation</div></li><li id="ch12.lt116" class="half_rhythm"><div>Faecal incontinence</div></li></ul></div></li></ul></div></li></ul>
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</td></tr><tr><th id="hd_b_ch12.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_ch12.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For non-functional complications:
|
|
<ul id="ch12.l30"><li id="ch12.lt117" class="half_rhythm"><div>Mesh removal (vaginal or abdominal)</div></li><li id="ch12.lt118" class="half_rhythm"><div>Resection</div></li><li id="ch12.lt119" class="half_rhythm"><div>Re-anastomosis</div></li><li id="ch12.lt120" class="half_rhythm"><div>Stoma</div></li></ul>
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For functional complications:
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<ul id="ch12.l31"><li id="ch12.lt121" class="half_rhythm"><div>Laxatives and aperients</div></li><li id="ch12.lt122" class="half_rhythm"><div>Lifestyle modifications: diet, exercise, weight loss</div></li><li id="ch12.lt123" class="half_rhythm"><div>Biofeedback</div></li><li id="ch12.lt124" class="half_rhythm"><div>Complex targeted laxatives: prucalopride, linaclotide</div></li><li id="ch12.lt125" class="half_rhythm"><div>Rectal irrigation</div></li><li id="ch12.lt126" class="half_rhythm"><div>Sacral nerve stimulation</div></li><li id="ch12.lt127" class="half_rhythm"><div>Laparoscopic ventral mesh rectopexy</div></li><li id="ch12.lt128" class="half_rhythm"><div>Stapled Transanal Resection of the Rectum (STARR)</div></li><li id="ch12.lt129" class="half_rhythm"><div>Stoma/Antegrade Colonic Enema (ACE)</div></li></ul></td></tr><tr><th id="hd_b_ch12.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_ch12.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l32" class="simple-list"><li id="ch12.lt130" class="half_rhythm"><div>Each management option against each other, separated according to the type of complication: non-functional or functional)</div></li></ul>
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</td></tr><tr><th id="hd_b_ch12.tab5_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch12.tab5_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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|
<ul id="ch12.l33"><li id="ch12.lt131" class="half_rhythm"><div>Reduction in bowel symptoms</div></li><li id="ch12.lt132" class="half_rhythm"><div>Adverse events (severe bleeding requiring blood transfusion; unintentional internal organ injury)</div></li><li id="ch12.lt133" class="half_rhythm"><div>Health-related quality of life</div></li></ul>
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<b>Important</b>
|
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<ul id="ch12.l34"><li id="ch12.lt134" class="half_rhythm"><div>Complications
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<ul id="ch12.l35" class="circle"><li id="ch12.lt135" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt136" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt137" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt138" class="half_rhythm"><div>Wound complications</div></li><li id="ch12.lt139" class="half_rhythm"><div>Mesh erosion or extrusion</div></li><li id="ch12.lt140" class="half_rhythm"><div>Sexual dysfunction</div></li></ul></div></li><li id="ch12.lt141" class="half_rhythm"><div>Patient satisfaction</div></li><li id="ch12.lt142" class="half_rhythm"><div>Repeat surgery for UI, POP or mesh complications</div></li><li id="ch12.lt143" class="half_rhythm"><div>Recurrence of urinary incontinence or prolapse</div></li></ul>
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Complications will be stratified as follows:
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<ul id="ch12.l36"><li id="ch12.lt144" class="half_rhythm"><div>Short-term: complications occurring after one year or less (≤ 1 year)</div></li><li id="ch12.lt145" class="half_rhythm"><div>Medium-term: complications occurring after one year and up to five years (> 1 year and ≤ 5 years)</div></li><li id="ch12.lt146" class="half_rhythm"><div>Long-term: complications occurring after 5 years (> 5 years)</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">POP, pelvic organ prolapse; UI, urinary incontinence.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab6"><div id="ch12.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Summary of included studies for complete mesh vaginal removal versus partial mesh vaginal removal in review of management of vaginal complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab6_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Study</p>
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<p>Country</p>
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<p>Type of study</p></th><th id="hd_h_ch12.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref8" rid="ch12.s1.ref8">Domingo 2005</a></p>
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<p>USA</p>
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<p>Prospective cohort</p></td><td headers="hd_h_ch12.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">9</td><td headers="hd_h_ch12.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Median age 54 (range 40–77)</p>
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<p>BMI: NR</p>
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<p>Parity: NR</p></td><td headers="hd_h_ch12.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">52</td><td headers="hd_h_ch12.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Transobturator synthetic sling</td><td headers="hd_h_ch12.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l37"><li id="ch12.lt147" class="half_rhythm"><div>Vaginal mesh extrusion/exposure 100%</div></li></ul></td><td headers="hd_h_ch12.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l38"><li id="ch12.lt148" class="half_rhythm"><div>Complete mesh vaginal removal 89%</div></li><li id="ch12.lt149" class="half_rhythm"><div>Partial mesh vaginal removal 11%</div></li></ul></td><td headers="hd_h_ch12.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Recurrent SUI</td></tr><tr><td headers="hd_h_ch12.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Jambusaria 2017</p>
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<p>USA</p>
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<p>Retrospective cohort</p></td><td headers="hd_h_ch12.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">94</td><td headers="hd_h_ch12.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 55.2 (12.1)</p>
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<p>BMI: 29.5 (6.9) kg/m<sup>2</sup></p>
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<p>Parity: 2.1 (1.2)</p></td><td headers="hd_h_ch12.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">~6 & ~29</td><td headers="hd_h_ch12.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Retropubic or transobturator synthetic sling</td><td headers="hd_h_ch12.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l39"><li id="ch12.lt150" class="half_rhythm"><div>Vaginal mesh extrusion/exposure 100%</div></li></ul></td><td headers="hd_h_ch12.tab6_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l40"><li id="ch12.lt151" class="half_rhythm"><div>Complete mesh vaginal removal 62%</div></li><li id="ch12.lt152" class="half_rhythm"><div>Partial mesh vaginal removal 38%</div></li></ul></td><td headers="hd_h_ch12.tab6_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Postoperative SUI</p>
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<p>Postoperative pain</p>
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<p>Postoperative de novo urgency</p>
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<p>Repeat SUI surgery</p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab7"><div id="ch12.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Study characteristics of case series studies in review of management of vaginal mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab7_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Study</p>
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<p>Country</p></th><th id="hd_h_ch12.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref2" rid="ch12.s1.ref2">Begley 2005</a></p>
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<p>USA</p></td><td headers="hd_h_ch12.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">7</td><td headers="hd_h_ch12.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 53.4</p>
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<p>BMI: NR</p>
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<p>Parity: Range 2–4</p></td><td headers="hd_h_ch12.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Unclear, data from last recorded follow up</td><td headers="hd_h_ch12.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Abdominal sacrocolpopexy</td><td headers="hd_h_ch12.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l41"><li id="ch12.lt153" class="half_rhythm"><div>Failure of conservative treatment for vaginal mesh erosion</div></li></ul></td><td headers="hd_h_ch12.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l42"><li id="ch12.lt154" class="half_rhythm"><div>Complete vaginal mesh removal if partial vaginal mesh removal not successful</div></li></ul></td><td headers="hd_h_ch12.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Repeat surgery for mesh complications</p>
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<p>POP recurrence</p></td></tr><tr><td headers="hd_h_ch12.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref4" rid="ch12.s1.ref4">Cheng 2017</a></p>
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<p>Taiwan</p></td><td headers="hd_h_ch12.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">36</td><td headers="hd_h_ch12.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 62.5 (11.2)</p>
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<p>BMI: 25.4 (3.5) kg/m<sup>2</sup></p>
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<p>Parity: 3.5 (1.5)</p></td><td headers="hd_h_ch12.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Median ~52</td><td headers="hd_h_ch12.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Various synthetic vaginal mesh kit including Elevate, Prolify, Gynemesh, Apogee/Perigee and Prosima</td><td headers="hd_h_ch12.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l43"><li id="ch12.lt155" class="half_rhythm"><div>Failure of conservative treatment for vaginal mesh erosion</div></li></ul></td><td headers="hd_h_ch12.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l44"><li id="ch12.lt156" class="half_rhythm"><div>Partial vaginal mesh removal</div></li></ul></td><td headers="hd_h_ch12.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Recurrent erosion</p>
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<p>Repeat surgery for mesh complications</p></td></tr><tr><td headers="hd_h_ch12.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref15" rid="ch12.s1.ref15">Kohli 1998</a></p>
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<p>USA</p></td><td headers="hd_h_ch12.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">7</td><td headers="hd_h_ch12.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age 56.4 (10)</p>
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<p>Weight (lb): 162.7 (42.6)</p>
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<p>Parity: 3.0 (1.2)</p></td><td headers="hd_h_ch12.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">79.6</td><td headers="hd_h_ch12.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Abdominal sacrocolpopexy</td><td headers="hd_h_ch12.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l45"><li id="ch12.lt157" class="half_rhythm"><div>Failure of conservative treatment for vaginal mesh erosion</div></li></ul></td><td headers="hd_h_ch12.tab7_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l46"><li id="ch12.lt158" class="half_rhythm"><div>Partial vaginal mesh removal</div></li></ul></td><td headers="hd_h_ch12.tab7_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Recurrent erosion</p>
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<p>Adverse events</p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab8"><div id="ch12.tab8" class="table"><h3><span class="label">Table 8</span><span class="title">Outcomes of case series studies on mesh removal in women who had abdominal sacrocolpopexy for treatment of POP</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab8_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcome</th><th id="hd_h_ch12.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;"># of studies</th><th id="hd_h_ch12.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;"># of participants</th><th id="hd_h_ch12.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rate (%)</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>Adverse events</b>
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</td><td headers="hd_h_ch12.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1<sup>a</sup></td><td headers="hd_h_ch12.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">5</td><td headers="hd_h_ch12.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">0.0</td></tr><tr><td headers="hd_h_ch12.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>Recurrent mesh exposure/extrusion</b>
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</td><td headers="hd_h_ch12.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1<sup>a</sup></td><td headers="hd_h_ch12.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">5</td><td headers="hd_h_ch12.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">0.0</td></tr><tr><td headers="hd_h_ch12.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>Repeat surgery for mesh exposure/extrusion</b>
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</td><td headers="hd_h_ch12.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1<sup>b</sup></td><td headers="hd_h_ch12.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">7</td><td headers="hd_h_ch12.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">57.1</td></tr><tr><td headers="hd_h_ch12.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>POP recurrence at mean 15.5-mo FU</b>
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</td><td headers="hd_h_ch12.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1<sup>b</sup></td><td headers="hd_h_ch12.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">7</td><td headers="hd_h_ch12.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">29.0</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Notes:</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="ch12.tab8_1"><p class="no_margin"><a class="bibr" href="#ch12.s1.ref15" rid="ch12.s1.ref15">Kohli. 1998</a>;</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="ch12.tab8_2"><p class="no_margin"><a class="bibr" href="#ch12.s1.ref2" rid="ch12.s1.ref2">Begley 2005</a>.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab9"><div id="ch12.tab9" class="table"><h3><span class="label">Table 9</span><span class="title">Outcomes of case series studies on mesh removal in women who had vaginal mesh kit for treatment of POP</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab9_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcome</th><th id="hd_h_ch12.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;"># of studies</th><th id="hd_h_ch12.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;"># of participants</th><th id="hd_h_ch12.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rate (%)</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>Recurrent mesh exposure/extrusion</b>
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</td><td headers="hd_h_ch12.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1</td><td headers="hd_h_ch12.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">36</td><td headers="hd_h_ch12.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">16.7</td></tr><tr><td headers="hd_h_ch12.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>Repeat surgery for mesh exposure/extrusion</b>
|
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</td><td headers="hd_h_ch12.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1</td><td headers="hd_h_ch12.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">36</td><td headers="hd_h_ch12.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">16.7</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Notes:</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="ch12.tab9_1"><p class="no_margin"><a class="bibr" href="#ch12.s1.ref4" rid="ch12.s1.ref4">Cheng 2017</a>.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab10"><div id="ch12.tab10" class="table"><h3><span class="label">Table 10</span><span class="title">Summary of included studies for complete mesh sling removal versus partial mesh sling removal in review of management of sexual dysfunction and/or pain mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab10/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab10_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Study</p>
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<p>Country</p>
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<p>Type of study</p></th><th id="hd_h_ch12.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab10_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref12" rid="ch12.s1.ref12">Hou 2014</a></p>
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<p>USA</p>
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<p>Prospective cohort</p></td><td headers="hd_h_ch12.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">69</td><td headers="hd_h_ch12.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<p>Mean age: 49 (range 41–63)</p>
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<p>BMI: 30 (range23–38) kg/m<sup>2</sup></p>
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</td><td headers="hd_h_ch12.tab10_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:middle;">>26</td><td headers="hd_h_ch12.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Synthetic mesh 56%</td><td headers="hd_h_ch12.tab10_1_1_1_6" rowspan="2" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l47"><li id="ch12.lt159" class="half_rhythm"><div>Persistent pain 100%</div></li></ul></td><td headers="hd_h_ch12.tab10_1_1_1_7" rowspan="2" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l48"><li id="ch12.lt160" class="half_rhythm"><div>Complete or partial mesh removal</div></li></ul></td><td headers="hd_h_ch12.tab10_1_1_1_8" rowspan="2" colspan="1" style="text-align:left;vertical-align:middle;"><p>Visual analogue scale pain scores</p>
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<p>Resolution of pain</p></td></tr><tr><td headers="hd_h_ch12.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">54</td><td headers="hd_h_ch12.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mean age: 53 (range 37–72)</p>
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<p>BMI: 27 (range24–36) kg/m<sup>2</sup></p></td><td headers="hd_h_ch12.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Synthetic tape (mesh sling) 44%</td></tr><tr><td headers="hd_h_ch12.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Jambusaria 2017</p><p>USA</p>
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<p>Retrospective cohort</p></td><td headers="hd_h_ch12.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">151</td><td headers="hd_h_ch12.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 51.3 (12)</p>
|
|
<p>BMI: 30 (6.5) kg/m<sup>2</sup></p>
|
|
<p>Parity: 2.2 (1.1)</p></td><td headers="hd_h_ch12.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">~6 & ~29</td><td headers="hd_h_ch12.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Retropubic or transobturator synthetic mesh sling</td><td headers="hd_h_ch12.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l49"><li id="ch12.lt161" class="half_rhythm"><div>Pain (including dyspareunia) 100%</div></li></ul></td><td headers="hd_h_ch12.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l50"><li id="ch12.lt162" class="half_rhythm"><div>Complete mesh removal 83%</div></li><li id="ch12.lt163" class="half_rhythm"><div>Partial mesh removal 17%</div></li></ul></td><td headers="hd_h_ch12.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Postoperative SUI</p>
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<p>Postoperative pain</p>
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<p>Postoperative de novo urgency</p>
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<p>Repeat SUI surgery</p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab11"><div id="ch12.tab11" class="table"><h3><span class="label">Table 11</span><span class="title">Study characteristics of case series studies in review of management of pain and/or sexual dysfunction complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab11/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab11_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Study</p>
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<p>Country</p>
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<p>Type of study</p></th><th id="hd_h_ch12.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab11_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab11_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref7" rid="ch12.s1.ref7">Danford 2015</a></p>
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<p>USA</p></td><td headers="hd_h_ch12.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">233</td><td headers="hd_h_ch12.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mean age: 54 (range 23–89)</p>
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<p>BMI: NR</p>
|
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<p>Parity: NR</p></td><td headers="hd_h_ch12.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Most recent follow up</td><td headers="hd_h_ch12.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Synthetic mesh sling with or without concomitant transvaginal mesh</td><td headers="hd_h_ch12.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l51"><li id="ch12.lt164" class="half_rhythm"><div>Vaginal and/or pelvic pain</div></li></ul></td><td headers="hd_h_ch12.tab11_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l52"><li id="ch12.lt165" class="half_rhythm"><div>Mesh division or mesh removal</div></li></ul></td><td headers="hd_h_ch12.tab11_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Improvement in pain status</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab12"><div id="ch12.tab12" class="table"><h3><span class="label">Table 12</span><span class="title">Pain status outcomes after mesh surgery (sling division or mesh sling removal) in women with or without mesh exposure</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab12/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab12_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcome<sup>a</sup></th><th id="hd_h_ch12.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;"># of participants</th><th id="hd_h_ch12.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mesh exposure (%)</th><th id="hd_h_ch12.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No mesh exposure (%)</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>Improvement in pain</b>
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</td><td headers="hd_h_ch12.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">169</td><td headers="hd_h_ch12.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">77</td><td headers="hd_h_ch12.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">67</td></tr><tr><td headers="hd_h_ch12.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>No change in pain status</b>
|
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</td><td headers="hd_h_ch12.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">45</td><td headers="hd_h_ch12.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">18</td><td headers="hd_h_ch12.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">21</td></tr><tr><td headers="hd_h_ch12.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<b>Worsening in pain</b>
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</td><td headers="hd_h_ch12.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">19</td><td headers="hd_h_ch12.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">5</td><td headers="hd_h_ch12.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">12</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Note:</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="ch12.tab12_1"><p class="no_margin">Data from <a class="bibr" href="#ch12.s1.ref7" rid="ch12.s1.ref7">Danford 2015</a>, n=233.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab13"><div id="ch12.tab13" class="table"><h3><span class="label">Table 13</span><span class="title">Study characteristics of case series studies in review of management of urinary mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab13/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab13_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;"><p>Study</p>
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<p>Country</p>
|
|
<p>Type of study</p></th><th id="hd_h_ch12.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref5" rid="ch12.s1.ref5">Crescenze. 2016</a></p>
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<p>USA</p>
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<p>Case series</p></td><td headers="hd_h_ch12.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">107</td><td headers="hd_h_ch12.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mean age: 54 (range 23–89)</p>
|
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<p>BMI: NR</p>
|
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<p>Parity: NR</p></td><td headers="hd_h_ch12.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Median ~126</td><td headers="hd_h_ch12.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Retropubic synthetic mesh sling 57%</p>
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<p>Transobturator synthetic mesh sling 43%</p></td><td headers="hd_h_ch12.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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|
<ul id="ch12.l53"><li id="ch12.lt166" class="half_rhythm"><div>Recurrent UTI 39%</div></li><li id="ch12.lt167" class="half_rhythm"><div>Retention requiring catheterisation 23%</div></li><li id="ch12.lt168" class="half_rhythm"><div>Obstructive voiding symptoms 90%</div></li><li id="ch12.lt169" class="half_rhythm"><div>SUI 28%</div></li></ul></td><td headers="hd_h_ch12.tab13_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l54"><li id="ch12.lt170" class="half_rhythm"><div>Mesh revision 21%</div></li><li id="ch12.lt171" class="half_rhythm"><div>Partial removal 79%</div></li></ul></td><td headers="hd_h_ch12.tab13_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Resolution of mesh complications</p>
|
|
<p>De novo SUI</p>
|
|
<p>SUI</p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab14"><div id="ch12.tab14" class="table"><h3><span class="label">Table 14</span><span class="title">Outcomes of mesh surgery to resolve urinary mesh sling complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab14/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab14_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcome<sup>a</sup></th><th id="hd_h_ch12.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"># of studies</th><th id="hd_h_ch12.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"># of participants</th><th id="hd_h_ch12.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Rate (%)</th></tr></thead><tbody><tr><th headers="hd_h_ch12.tab14_1_1_1_1" id="hd_b_ch12.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Resolution of obstructive voiding symptoms</th><td headers="hd_h_ch12.tab14_1_1_1_2 hd_b_ch12.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">1</td><td headers="hd_h_ch12.tab14_1_1_1_3 hd_b_ch12.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">107</td><td headers="hd_h_ch12.tab14_1_1_1_4 hd_b_ch12.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">78.9</td></tr><tr><th headers="hd_h_ch12.tab14_1_1_1_1" id="hd_b_ch12.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Resolution of need for catheterisation</th><td headers="hd_h_ch12.tab14_1_1_1_2 hd_b_ch12.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">1</td><td headers="hd_h_ch12.tab14_1_1_1_3 hd_b_ch12.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">107</td><td headers="hd_h_ch12.tab14_1_1_1_4 hd_b_ch12.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">95.8</td></tr><tr><th headers="hd_h_ch12.tab14_1_1_1_1" id="hd_b_ch12.tab14_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Resolution of recurrent UTI</th><td headers="hd_h_ch12.tab14_1_1_1_2 hd_b_ch12.tab14_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">1</td><td headers="hd_h_ch12.tab14_1_1_1_3 hd_b_ch12.tab14_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">107</td><td headers="hd_h_ch12.tab14_1_1_1_4 hd_b_ch12.tab14_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">65.8</td></tr><tr><th headers="hd_h_ch12.tab14_1_1_1_1" id="hd_b_ch12.tab14_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">De novo SUI</th><td headers="hd_h_ch12.tab14_1_1_1_2 hd_b_ch12.tab14_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">1</td><td headers="hd_h_ch12.tab14_1_1_1_3 hd_b_ch12.tab14_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">107</td><td headers="hd_h_ch12.tab14_1_1_1_4 hd_b_ch12.tab14_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">35.5</td></tr><tr><th headers="hd_h_ch12.tab14_1_1_1_1" id="hd_b_ch12.tab14_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">SUI</th><td headers="hd_h_ch12.tab14_1_1_1_2 hd_b_ch12.tab14_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">1</td><td headers="hd_h_ch12.tab14_1_1_1_3 hd_b_ch12.tab14_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">107</td><td headers="hd_h_ch12.tab14_1_1_1_4 hd_b_ch12.tab14_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">57.0</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Notes:</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="ch12.tab14_1"><p class="no_margin">Data from <a class="bibr" href="#ch12.s1.ref5" rid="ch12.s1.ref5">Crescenze 2016</a>, n=107.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab15"><div id="ch12.tab15" class="table"><h3><span class="label">Table 15</span><span class="title">Study characteristics of included cohort studies for partial versus complete mesh removal in review of management of mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab15/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab15_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab15_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Study</p>
|
|
<p>Country</p>
|
|
<p>Type of study</p></th><th id="hd_h_ch12.tab15_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab15_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab15_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab15_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab15_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab15_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab15_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab15_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref11" rid="ch12.s1.ref11">Hokenstad 2015</a></p>
|
|
<p>USA</p>
|
|
<p>Retrospective cohort</p></td><td headers="hd_h_ch12.tab15_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">41</td><td headers="hd_h_ch12.tab15_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 52 (11)</p>
|
|
<p>BMI: 28.0 (5.1) kg/m<sup>2</sup></p>
|
|
<p>Median Parity: 2 (range 0–5)</p></td><td headers="hd_h_ch12.tab15_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"></td><td headers="hd_h_ch12.tab15_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mesh augmentation 17%</p>
|
|
<p>Mesh kit 83%</p></td><td headers="hd_h_ch12.tab15_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l55"><li id="ch12.lt172" class="half_rhythm"><div>Dyspareunia or de novo pain 82%</div></li><li id="ch12.lt173" class="half_rhythm"><div>Faecal incontinence 15%</div></li><li id="ch12.lt174" class="half_rhythm"><div>Urinary urgency and/or urge incontinence 31%</div></li><li id="ch12.lt175" class="half_rhythm"><div>Vaginal bleeding or discharge 51%</div></li></ul></td><td headers="hd_h_ch12.tab15_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Complete mesh removal 59%</p>
|
|
<p>Partial mesh removal 41%</p></td><td headers="hd_h_ch12.tab15_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Continence-specific health-related quality of life</p>
|
|
<p>Dyspareunia</p>
|
|
<p>Health-related quality of life</p>
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<p>Improvement</p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab16"><div id="ch12.tab16" class="table"><h3><span class="label">Table 16</span><span class="title">Study characteristics of included cohort studies for mesh division versus complete or partial mesh removal in review of management of mesh sling complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab16/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab16_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Study</p>
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<p>Country</p>
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<p>Type of study</p></th><th id="hd_h_ch12.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab16_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab16_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab16_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab16_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref24" rid="ch12.s1.ref24">Shaw 2017</a></p>
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<p>USA</p>
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<p>Retrospective cohort</p></td><td headers="hd_h_ch12.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">102</td><td headers="hd_h_ch12.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mean age: 53.5</p>
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<p>Mean BMI: 25.1 kg/m<sup>2</sup></p>
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<p>Median parity: 2</p></td><td headers="hd_h_ch12.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Range ~4–336</td><td headers="hd_h_ch12.tab16_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Retropubic synthetic sling 67%</p>
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<p>Transobturator synthetic sling 33%</p></td><td headers="hd_h_ch12.tab16_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l56"><li id="ch12.lt176" class="half_rhythm"><div>Mesh erosion/exposure/infection 42%</div></li><li id="ch12.lt177" class="half_rhythm"><div>Pain 9%</div></li><li id="ch12.lt178" class="half_rhythm"><div>Voiding dysfunction 49%</div></li></ul></td><td headers="hd_h_ch12.tab16_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l57"><li id="ch12.lt179" class="half_rhythm"><div>Complete or partial mesh removal 56%</div></li><li id="ch12.lt180" class="half_rhythm"><div>Mesh division 44%</div></li></ul></td><td headers="hd_h_ch12.tab16_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Repeat surgery</p>
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<p>Recurrent SUI</p></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab17"><div id="ch12.tab17" class="table"><h3><span class="label">Table 17</span><span class="title">Study characteristics of included cohort studies for removal of synthetic transobturator versus retropubic mesh sling for management of women with mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab17/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab17_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Study</p>
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<p>Country</p>
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<p>Type of study</p></th><th id="hd_h_ch12.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab17_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab17_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab17_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref22" rid="ch12.s1.ref22">Ramart. 2017</a></p>
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<p>USA</p>
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<p>Retrospective cohort</p></td><td headers="hd_h_ch12.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">117</td><td headers="hd_h_ch12.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 56.34 (10.7)</p>
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<p>BMI: 28.4 (5.5) kg/m<sup>2</sup></p>
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<p>Vaginal delivery: 2.14 (1.4)</p></td><td headers="hd_h_ch12.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">>12 weeks</td><td headers="hd_h_ch12.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Retropubic synthetic sling 60%</p>
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<p>Transobturator synthetic sling 40%</p></td><td headers="hd_h_ch12.tab17_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l58"><li id="ch12.lt181" class="half_rhythm"><div>Bladder outlet obstruction 56%</div></li><li id="ch12.lt182" class="half_rhythm"><div>Dyspareunia 47%</div></li><li id="ch12.lt183" class="half_rhythm"><div>Irritation 72%</div></li><li id="ch12.lt184" class="half_rhythm"><div>Groin pain 22%</div></li><li id="ch12.lt185" class="half_rhythm"><div>Hispareunia 7%</div></li><li id="ch12.lt186" class="half_rhythm"><div>Leg pain 17%</div></li><li id="ch12.lt187" class="half_rhythm"><div>Pelvic pain 32%</div></li><li id="ch12.lt188" class="half_rhythm"><div>Suprapubic pain 22%</div></li><li id="ch12.lt189" class="half_rhythm"><div>Urge incontinence 33%</div></li><li id="ch12.lt190" class="half_rhythm"><div>Urinary retention 14%</div></li><li id="ch12.lt191" class="half_rhythm"><div>Urinary tract mesh exposure 8%</div></li><li id="ch12.lt192" class="half_rhythm"><div>UTI 38%</div></li><li id="ch12.lt193" class="half_rhythm"><div>Vagina mesh exposure 31%</div></li></ul></td><td headers="hd_h_ch12.tab17_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l59"><li id="ch12.lt194" class="half_rhythm"><div>Complete mesh removal 51%</div></li><li id="ch12.lt195" class="half_rhythm"><div>Mesh division or partial mesh removal 49%</div></li></ul></td><td headers="hd_h_ch12.tab17_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Repeat surgery</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12tab18"><div id="ch12.tab18" class="table"><h3><span class="label">Table 18</span><span class="title">Study characteristics of included case series studies on the general management of mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab18/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab18_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Study Country</th><th id="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Number of participants</th><th id="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Characteristics<sup>a</sup></th><th id="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Length of follow up (weeks)</th><th id="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Original surgery<sup>b</sup></th><th id="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Main reasons for referral<sup>c</sup></th><th id="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Interventions<sup>d</sup></th><th id="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref1" rid="ch12.s1.ref1">Abbott 2014</a></p>
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<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">347</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 56.6 (12.7)</p>
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<p>BMI: 28.4 (5.3) kg/m<sup>2</sup></p>
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<p>Parity: 2.6 (1.24)</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Unclear, data from last recorded follow up</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Sacrocolpopexy only 5%</p>
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<p>Sacrocolpopexy + Synthetic sling 2%</p>
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<p>Synthetic sling only 50%</p>
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<p>TVM only 21%</p>
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<p>TVM + Synthetic sling 22%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l60"><li id="ch12.lt196" class="half_rhythm"><div>Any lower gastrointestinal tract symptom 6%</div></li><li id="ch12.lt197" class="half_rhythm"><div>Any vaginal symptom 46%</div></li><li id="ch12.lt198" class="half_rhythm"><div>Dyspareunia 30%</div></li><li id="ch12.lt199" class="half_rhythm"><div>Localised infection 11% Lower urinary tract symptoms 49%</div></li><li id="ch12.lt200" class="half_rhythm"><div>Mesh erosion/exposure/extrusion 43%</div></li><li id="ch12.lt201" class="half_rhythm"><div>Pain 36%</div></li><li id="ch12.lt202" class="half_rhythm"><div>Recurrent or de novo prolapse 14%</div></li><li id="ch12.lt203" class="half_rhythm"><div>Recurrent or de novo incontinence 25%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l61"><li id="ch12.lt204" class="half_rhythm"><div>Complete mesh removal 27%</div></li><li id="ch12.lt205" class="half_rhythm"><div>Partial mesh removal 51%</div></li><li id="ch12.lt206" class="half_rhythm"><div>Recurrent POP treatment 23%</div></li><li id="ch12.lt207" class="half_rhythm"><div>Recurrent incontinence treatment 15%</div></li><li id="ch12.lt208" class="half_rhythm"><div>Release of mesh arms 18%</div></li><li id="ch12.lt209" class="half_rhythm"><div>Other 20%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Repeat surgery</td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref3" rid="ch12.s1.ref3">Cardenas-Trowers 2017</a></p>
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<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">83</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 56 (11)</p>
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<p>BMI: 29 (6) kg/m<sup>2</sup></p>
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<p>Parity: Median 3 (range 0–6)</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Range 4–6</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Anterior prolapse mesh 7%</p>
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<p>Posterior prolapse mesh 4%</p>
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<p>Apical prolapse mesh 4%</p>
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<p>Multi-compartment prolapse mesh 32%</p>
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<p>Synthetic sling 33%</p>
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<p>Synthetic sling + Prolapse mesh 19%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l62"><li id="ch12.lt210" class="half_rhythm"><div>Abdominal pain 6%</div></li><li id="ch12.lt211" class="half_rhythm"><div>Buttock pain 4%</div></li><li id="ch12.lt212" class="half_rhythm"><div>Dyspareunia 55%</div></li><li id="ch12.lt213" class="half_rhythm"><div>Leg pain 6%</div></li><li id="ch12.lt214" class="half_rhythm"><div>Mesh erosion 43%</div></li><li id="ch12.lt215" class="half_rhythm"><div>Pelvic pain 50%</div></li><li id="ch12.lt216" class="half_rhythm"><div>Rectal pain 12%</div></li><li id="ch12.lt217" class="half_rhythm"><div>Urinary retention 16%</div></li><li id="ch12.lt218" class="half_rhythm"><div>Vaginal bleeding 29%</div></li><li id="ch12.lt219" class="half_rhythm"><div>Vaginal discharge 19%</div></li><li id="ch12.lt220" class="half_rhythm"><div>Vaginal pain 62%</div></li><li id="ch12.lt221" class="half_rhythm"><div>Voiding dysfunction 13%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l63"><li id="ch12.lt222" class="half_rhythm"><div>Mesh revision or removal 100%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Adverse events</p>
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<p>Repeat surgery</p>
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<p>Complications related to surgery to resolve mesh complications</p></td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref6" rid="ch12.s1.ref6">Crosby 2014</a></p>
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<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">90</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 58 (11)</p><p>BMI: 29.5 (11) kg/m<sup>2</sup></p>
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<p>Parity: 3 (range 0–10)</p>
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</td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Median ~16</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Various synthetic TVM including Perigee 24%, Apogee 20%, Anterior Prolift 19%, Anterior Avaulta 17%, Posterior Prolift 12% and Posterior Avaulta 11%</td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l64"><li id="ch12.lt223" class="half_rhythm"><div>Bulge sensation 30%</div></li><li id="ch12.lt224" class="half_rhythm"><div>Defecatory dysfunction 35%</div></li><li id="ch12.lt225" class="half_rhythm"><div>Dyspareunia 48%</div></li><li id="ch12.lt226" class="half_rhythm"><div>Mesh exposure 62%</div></li><li id="ch12.lt227" class="half_rhythm"><div>Pelvic or vaginal pain 64% Recurrent infection 9%</div></li><li id="ch12.lt228" class="half_rhythm"><div>Rectovaginal fistula 3%</div></li><li id="ch12.lt229" class="half_rhythm"><div>SUI 28%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l65"><li id="ch12.lt230" class="half_rhythm"><div>Anterior mesh removal 56%</div></li><li id="ch12.lt231" class="half_rhythm"><div>Anterior +posterior mesh removal 23%</div></li><li id="ch12.lt232" class="half_rhythm"><div>Posterior mesh removal 21%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Repeat surgery</p>
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<p>Resolution of mesh complications (all/mesh erosion/pain/dyspareunia)</p>
|
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<p>Complications related to surgery to resolve mesh complications</p></td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref9" rid="ch12.s1.ref9">Fabian 2015</a></p>
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<p>Poland</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">67</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 61.5 (range 38–93)</p>
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<p>BMI/parity: NR</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Mean 168.1</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Retropubic synthetic sling 52%</p>
|
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<p>Transobturator synthetic sling 45%</p>
|
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<p>Two synthetic slings 3%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
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<ul id="ch12.l66"><li id="ch12.lt233" class="half_rhythm"><div>Mesh erosion 25%</div></li><li id="ch12.lt234" class="half_rhythm"><div>Overactive bladder 64%</div></li><li id="ch12.lt235" class="half_rhythm"><div>Pain (including dyspareunia) 40%</div></li><li id="ch12.lt236" class="half_rhythm"><div>SUI 59%</div></li><li id="ch12.lt237" class="half_rhythm"><div>Urinary retention 40%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
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<ul id="ch12.l67"><li id="ch12.lt238" class="half_rhythm"><div>Complete mesh removal 100%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Resolution of mesh complications (pain/urinary)</td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref10" rid="ch12.s1.ref10">George. 2013</a></p>
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<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">71</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 57.4 (10.2)</p>
|
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<p>BMI: 30.9 (13.2) kg/m<sup>2</sup></p>
|
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<p>Parity: 2.5 (1.2)</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Mean 38.7</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Abdominal sacrocolpopexy 14%</p>
|
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<p>Laparoscopic sacrocolpopexy 42%</p>
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<p>Other 3%</p>
|
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<p>Vaginal mesh kit 41%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l68"><li id="ch12.lt239" class="half_rhythm"><div>Dyspareunia 12%</div></li><li id="ch12.lt240" class="half_rhythm"><div>Mesh exposure/extrusion 56%</div></li><li id="ch12.lt241" class="half_rhythm"><div>Pelvic pain 16%</div></li><li id="ch12.lt242" class="half_rhythm"><div>Vaginal bleeding/discharge 16%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l69"><li id="ch12.lt243" class="half_rhythm"><div>Complete mesh removal 37%</div></li><li id="ch12.lt244" class="half_rhythm"><div>Partial mesh removal 63%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Adverse events</p>
|
|
<p>Repeat surgery</p>
|
|
<p>Recurrent POP</p></td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref16" rid="ch12.s1.ref16">Lee 2013</a></p>
|
|
<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">58</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 54.6 (range 32–80)</p>
|
|
<p>BMI/parity: NR</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Mean 53.3</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Anterior TVM only 29%</p>
|
|
<p>Anterior TVM + SIMS 2%</p>
|
|
<p>Anterior TVM + retropubic synthetic sling 31%</p>
|
|
<p>Anterior + posterior TVM only 10%</p>
|
|
<p>Anterior + posterior TVM + retropubic synthetic sling 7%</p>
|
|
<p>Anterior TVM + transobturator synthetic sling 16%</p><p>Anterior + posterior TVM + retropubic synthetic sling 6%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l70"><li id="ch12.lt245" class="half_rhythm"><div>Dyspareunia 72%</div></li><li id="ch12.lt246" class="half_rhythm"><div>Infection 9%</div></li><li id="ch12.lt247" class="half_rhythm"><div>Mesh exposure 74%</div></li><li id="ch12.lt248" class="half_rhythm"><div>MUI 29%</div></li><li id="ch12.lt249" class="half_rhythm"><div>Pelvic pain 45%</div></li><li id="ch12.lt250" class="half_rhythm"><div>Recurrent UTI 16%</div></li><li id="ch12.lt251" class="half_rhythm"><div>SUI 9%</div></li><li id="ch12.lt252" class="half_rhythm"><div>Urge incontinence 19%</div></li><li id="ch12.lt253" class="half_rhythm"><div>Vaginal discharge 21%</div><div>Vesicovaginal fistula 2%</div></li><li id="ch12.lt254" class="half_rhythm"><div>Voiding dysfunction 16%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l71"><li id="ch12.lt255" class="half_rhythm"><div>Mesh removal 100%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Adverse events</p>
|
|
<p>Repeat surgery</p>
|
|
<p>Resolution of mesh complications (pain/dyspareunia)</p>
|
|
<p>Recurrent POP</p>
|
|
<p>Complications related to surgery to resolve mesh complications</p></td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref17" rid="ch12.s1.ref17">Marcus-Braun 2010</a><sup>e</sup></p>
|
|
<p>France</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">83</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Age/BMI/parity: NR</td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">6 or ~24</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">TVM</td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l72"><li id="ch12.lt256" class="half_rhythm"><div>Granuloma 9%</div></li><li id="ch12.lt257" class="half_rhythm"><div>Incomplete voiding 15%</div></li><li id="ch12.lt258" class="half_rhythm"><div>Infection 21%</div></li><li id="ch12.lt259" class="half_rhythm"><div>Malposition 4%</div></li><li id="ch12.lt260" class="half_rhythm"><div>Mesh erosion 39%</div></li><li id="ch12.lt261" class="half_rhythm"><div>Pain 8%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l73"><li id="ch12.lt262" class="half_rhythm"><div>Complete mesh removal</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Adverse events</p>
|
|
<p>Repeat surgery</p>
|
|
<p>Recurrent POP/SUI</p>
|
|
<p>Complications related to surgery to resolve mesh complications</p></td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref18" rid="ch12.s1.ref18">Misrai 2009</a></p>
|
|
<p>France</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">75</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 60.7 (12)</p>
|
|
<p>Median BMI: 27 kg/m<sup>2</sup></p>
|
|
<p>Parity: NR</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Mean 157.4</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Retropubic or transobturator synthetic sling</td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l74"><li id="ch12.lt263" class="half_rhythm"><div>Bladder outlet obstruction 39%</div></li><li id="ch12.lt264" class="half_rhythm"><div>Chronic pelvic pain 21%</div></li><li id="ch12.lt265" class="half_rhythm"><div>De novo incontinence or urgency 7%</div></li><li id="ch12.lt266" class="half_rhythm"><div>Mesh erosion/extrusion 32%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l75"><li id="ch12.lt267" class="half_rhythm"><div>Complete mesh removal 45%</div></li><li id="ch12.lt268" class="half_rhythm"><div>Partial mesh removal 55%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Recurrent SUI</td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref19" rid="ch12.s1.ref19">Parden 2016</a></p>
|
|
<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">69</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 54 (11.4)</p>
|
|
<p>BMI <25 kg/m<sup>2</sup>: 19%</p>
|
|
<p>BMI 25–39 kg/m<sup>2</sup>: 71%</p>
|
|
<p>BMI >30 kg/m<sup>2</sup>: 10%</p>
|
|
<p>Vaginal delivery: Median 2 (range 2–3)</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">≥52</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Synthetic mini-sing 12%</p>
|
|
<p>Other synthetic sling 3%</p>
|
|
<p>Retropubic synthetic sling 46%</p>
|
|
<p>Transobturator synthetic sling 46%</p>
|
|
<p>Unknown 6%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l76"><li id="ch12.lt269" class="half_rhythm"><div>Dyspareunia 35%</div></li><li id="ch12.lt270" class="half_rhythm"><div>Leg, groin, pelvic or vaginal pain 42%</div></li><li id="ch12.lt271" class="half_rhythm"><div>Mesh erosion/extrusion 42%</div></li><li id="ch12.lt272" class="half_rhythm"><div>Recurrent UTI 15%</div></li><li id="ch12.lt273" class="half_rhythm"><div>Urinary incontinence 13%</div></li><li id="ch12.lt274" class="half_rhythm"><div>Voiding dysfunction 29%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l77"><li id="ch12.lt275" class="half_rhythm"><div>Complete mesh removal 51%</div></li><li id="ch12.lt276" class="half_rhythm"><div>Mesh division 20%</div></li><li id="ch12.lt277" class="half_rhythm"><div>Partial mesh removal 44%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Resolution of mesh complications (pain/dyspareunia)</td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref20" rid="ch12.s1.ref20">Pickett 2015</a><sup>f</sup><sup>,</sup><sup>g</sup></p>
|
|
<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">374</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 55.2 (11.8)</p><p>BMI: 29.1 (6.8) kg/m<sup>2</sup></p>
|
|
<p>Median parity: 2 (IQR 2–3)</p>
|
|
</td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">~28</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Vaginal mesh 44%</p>
|
|
<p>Sacrocolpopexy 34%</p>
|
|
<p>Synthetic sling 77%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l78"><li id="ch12.lt278" class="half_rhythm"><div>Dyspareunia 57%</div></li><li id="ch12.lt279" class="half_rhythm"><div>Mesh exposure 54%</div></li><li id="ch12.lt280" class="half_rhythm"><div>Pain 63%</div></li><li id="ch12.lt281" class="half_rhythm"><div>Voiding dysfunction 39%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l79"><li id="ch12.lt282" class="half_rhythm"><div>Mesh revision or removal</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Adverse events</td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref21" rid="ch12.s1.ref21">Rac 2017</a><sup>f</sup></p>
|
|
<p>USA</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">277</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Age: 57.2 (12)</p>
|
|
<p>BMI: 29.5 (6.4) kg/m<sup>2</sup></p>
|
|
<p>Parity: NR</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Mean 58.1</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mesh for SUI 55%</p>
|
|
<p>Mesh for POP 5%</p>
|
|
<p>Mesh for SUI + POP 39%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l80"><li id="ch12.lt283" class="half_rhythm"><div>Bladder outlet obstruction/urinary retention 55%</div></li><li id="ch12.lt284" class="half_rhythm"><div>Bladder or urethra mesh erosion 15%</div></li><li id="ch12.lt285" class="half_rhythm"><div>Lower urinary tract symptoms 16%</div></li><li id="ch12.lt286" class="half_rhythm"><div>Vaginal mesh extrusion 33%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l81"><li id="ch12.lt287" class="half_rhythm"><div>Mesh revision, complete mesh removal, or partial mesh removal</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Repeat surgery</p>
|
|
<p>Complications related to surgery to resolve mesh complications</p></td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref23" rid="ch12.s1.ref23">Renezeder 2011</a><sup>h</sup></p>
|
|
<p>Germany</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">118</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Age/BMI/parity: NR</td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">8</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Various alloplastic materials including 72 cases of TVT, 11 cases of TOT-Obtape, 28 cases of other types of synthetic sling/TVM, and 9 cases mesh used not known</td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l82"><li id="ch12.lt288" class="half_rhythm"><div>De novo urgency 47%</div></li><li id="ch12.lt289" class="half_rhythm"><div>Infection 16%</div></li><li id="ch12.lt290" class="half_rhythm"><div>Mesh erosion 37%</div></li><li id="ch12.lt291" class="half_rhythm"><div>Pain (including dyspareunia) 42%</div></li><li id="ch12.lt292" class="half_rhythm"><div>Recurrent UTI and postvoiding residual urine>100 cm<sup>3</sup> 39%</div></li><li id="ch12.lt293" class="half_rhythm"><div>Vesicovaginal fistula 2%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l83"><li id="ch12.lt294" class="half_rhythm"><div>Bone stabilisation 1%</div></li><li id="ch12.lt295" class="half_rhythm"><div>Complete mesh removal via laparotomy 13%</div></li><li id="ch12.lt296" class="half_rhythm"><div>Excision of granulation tissue 3%</div></li><li id="ch12.lt297" class="half_rhythm"><div>Partial mesh removal 65%</div></li><li id="ch12.lt298" class="half_rhythm"><div>Tissue patch covering 18%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Complications related to surgery to resolve mesh complications</td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref25" rid="ch12.s1.ref25">Skala 2011</a><sup>h</sup><sup>,</sup><sup>i</sup></p>
|
|
<p>Germany</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">54</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mean age: 59.4 (range 33–82)</p>
|
|
<p>BMI/parity: NR</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">~12</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Various alloplastic materials including 33 cases of polypropylene mesh, 5 cases of other types of mesh, and 16 cases mesh used not known</td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l84"><li id="ch12.lt299" class="half_rhythm"><div>Dyspareunia 17%</div></li><li id="ch12.lt300" class="half_rhythm"><div>Local infection 33%</div></li><li id="ch12.lt301" class="half_rhythm"><div>Mesh erosion >1cm 56%</div></li><li id="ch12.lt302" class="half_rhythm"><div>Pain 50%</div></li><li id="ch12.lt303" class="half_rhythm"><div>Urgency 20%</div></li><li id="ch12.lt304" class="half_rhythm"><div>Vaginal discharge 48%</div></li><li id="ch12.lt305" class="half_rhythm"><div>Vaginal bleeding 15%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l85"><li id="ch12.lt306" class="half_rhythm"><div>Partial mesh removal + tissue patch covering 17%</div></li><li id="ch12.lt307" class="half_rhythm"><div>Partial mesh removal + vaginal revision 91%</div></li><li id="ch12.lt308" class="half_rhythm"><div>Wide mesh removal + laparotomy 19%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Recurrent POP</p>
|
|
<p>Repeat surgery</p>
|
|
<p>Resolution of mesh complications (all/erosion/pain/dyspareunia/urinary)</p></td></tr><tr><td headers="hd_h_ch12.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p><a class="bibr" href="#ch12.s1.ref26" rid="ch12.s1.ref26">Warembourg 2017</a></p>
|
|
<p>France</p></td><td headers="hd_h_ch12.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">68</td><td headers="hd_h_ch12.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Mean age: 61.8 (range 35–84)</p>
|
|
<p>Mean BMI: 25.1 (range 14.2–44.4) kg/m<sup>2</sup></p>
|
|
<p>Parity: NR</p></td><td headers="hd_h_ch12.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Mean 168.1</td><td headers="hd_h_ch12.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Hysterectomy 25%</p>
|
|
<p>Sacrocolpopexy 10%</p>
|
|
<p>TVM repair 3%</p>
|
|
<p>Transvaginal native repair 12%</p>
|
|
<p>Unknown surgery 5%</p>
|
|
<p>Urinary incontinence surgery 19%</p></td><td headers="hd_h_ch12.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l86"><li id="ch12.lt309" class="half_rhythm"><div>Bladder mesh extrusion 6%</div></li><li id="ch12.lt310" class="half_rhythm"><div>Medically-refractory neuropathic pain 4%</div></li><li id="ch12.lt311" class="half_rhythm"><div>Pelvic abscess 12%</div></li><li id="ch12.lt312" class="half_rhythm"><div>Rectal mesh extrusion 1%</div></li><li id="ch12.lt313" class="half_rhythm"><div>Rectovisical fistula 1%</div></li><li id="ch12.lt314" class="half_rhythm"><div>Symptomatic mesh contraction 20%</div></li><li id="ch12.lt315" class="half_rhythm"><div>Ureteral kinking 3%</div></li><li id="ch12.lt316" class="half_rhythm"><div>Vaginal mesh exposure 48%</div></li><li id="ch12.lt317" class="half_rhythm"><div>Vesicovaginal fistula 3%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<ul id="ch12.l87"><li id="ch12.lt318" class="half_rhythm"><div>Partial mesh removal 65%</div></li><li id="ch12.lt319" class="half_rhythm"><div>Anterior TVM repair 51%</div></li><li id="ch12.lt320" class="half_rhythm"><div>Posterior TVM repair 7%</div></li><li id="ch12.lt321" class="half_rhythm"><div>Anterior + posterior TVM repair 13%</div></li><li id="ch12.lt322" class="half_rhythm"><div>Anterior sacrocolpopexy mesh repair 3%</div></li><li id="ch12.lt323" class="half_rhythm"><div>Anterior + posterior sacrocolpopexy mesh repair 16%</div></li><li id="ch12.lt324" class="half_rhythm"><div>Anterior sacrocolpopexy + rectopexy mesh repair 6%</div></li><li id="ch12.lt325" class="half_rhythm"><div>Rectopexy mesh repair 3%</div></li></ul></td><td headers="hd_h_ch12.tab18_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;"><p>Repeat surgery</p>
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<p>Resolution of mesh complications (all)</p></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Notes:</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="ch12.tab18_1"><p class="no_margin">Data for age, BMI, and parity is given as mean and standard deviation unless otherwise stated;</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="ch12.tab18_2"><p class="no_margin">Participants may have had more than one type of mesh inserted. Many participants may have also had concomitant surgery (not shown);</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="ch12.tab18_3"><p class="no_margin">Majority of participants had more than two or more indications for surgery to resolve mesh complications;</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="ch12.tab18_4"><p class="no_margin">all participants received stated intervention unless otherwise stated. Participants may have had concomitant procedure for POP and/or SUI if indicated;</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="ch12.tab18_5"><p class="no_margin">Reasons for referral are given in percentage of all 114 indications (84 patients reported 114 mesh complications);</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="ch12.tab18_6"><p class="no_margin">Data for relevant types of surgery received or sling used not reported;</p></div></dd></dl><dl class="bkr_refwrap"><dt>g</dt><dd><div id="ch12.tab18_7"><p class="no_margin"><a class="bibr" href="#ch12.s1.ref20" rid="ch12.s1.ref20">Pickett 2015</a>: 82% had single-compartment mesh removal surgery, 12% had multi-compartment removal surgery, and 6% surgery not known;</p></div></dd></dl><dl class="bkr_refwrap"><dt>h</dt><dd><div id="ch12.tab18_8"><p class="no_margin">Data for some of the POP participants in <a class="bibr" href="#ch12.s1.ref25" rid="ch12.s1.ref25">Skala 2011</a> are probably included the data reported for the sample in <a class="bibr" href="#ch12.s1.ref23" rid="ch12.s1.ref23">Renezeder 2011</a>;</p></div></dd></dl><dl class="bkr_refwrap"><dt>i</dt><dd><div id="ch12.tab18_9"><p class="no_margin">Participants in <a class="bibr" href="#ch12.s1.ref25" rid="ch12.s1.ref25">Skala 2011</a> may have received more than one intervention to resolve mesh complications. Abbreviations: IQR, interquartile range; MUI, mixed urinary incontinence; NR, not reported; TVM, transvaginal mesh; UTI, urinary tract infection.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12tab19"><div id="ch12.tab19" class="table"><h3><span class="label">Table 19</span><span class="title">Outcomes of surgery to resolve mesh complications for review of general management of complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.tab19/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.tab19_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.tab19_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch12.tab19_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcome</th><th id="hd_h_ch12.tab19_1_1_1_2" colspan="3" rowspan="1" style="text-align:left;vertical-align:bottom;">Mesh removal<sup>a</sup></th><th id="hd_h_ch12.tab19_1_1_1_3" colspan="3" rowspan="1" style="text-align:left;vertical-align:bottom;">Various<sup>b</sup></th></tr><tr><th headers="hd_h_ch12.tab19_1_1_1_2" id="hd_h_ch12.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:bottom;"># of studies</th><th headers="hd_h_ch12.tab19_1_1_1_2" id="hd_h_ch12.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:bottom;">Total # of women</th><th headers="hd_h_ch12.tab19_1_1_1_2" id="hd_h_ch12.tab19_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:bottom;">Rate (%)<sup>c</sup></th><th headers="hd_h_ch12.tab19_1_1_1_3" id="hd_h_ch12.tab19_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:bottom;"># of studies</th><th headers="hd_h_ch12.tab19_1_1_1_3" id="hd_h_ch12.tab19_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:bottom;">Total # of women</th><th headers="hd_h_ch12.tab19_1_1_1_3" id="hd_h_ch12.tab19_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:bottom;">Rate (%)<sup>c</sup></th></tr></thead><tbody><tr><td headers="hd_h_ch12.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adverse events</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">4</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">614</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">3.4</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">83</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.2</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Repeat surgery</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">7</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">728</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15.5</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">430</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">20.7</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Recurrent SUI</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">75</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">24.0</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">83</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">16.9</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Recurrent POP</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">3</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">177</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">10.2</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">123</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">6.5</td></tr><tr><th headers="hd_h_ch12.tab19_1_1_1_1 hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_h_ch12.tab19_1_1_2_2 hd_h_ch12.tab19_1_1_2_3 hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_h_ch12.tab19_1_1_2_5 hd_h_ch12.tab19_1_1_2_6" id="hd_b_ch12.tab19_1_1_5_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:middle;">Resolution of mesh complications</th></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All mesh complications</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">4</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">257</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">31.9</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mesh erosion/extrusion/exposure</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">86</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">90.7</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">5</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">231</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">58.4</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dyspareunia</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">4</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">127</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">32.3</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary – <i>any</i></td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">127</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">37.0</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:right;vertical-align:top;">
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<i>Urgency</i>
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</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">63.6</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:right;vertical-align:top;">
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<i>Other</i>
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|
</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">6</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">66.7</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bowel</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">7</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">100</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td></tr><tr><th headers="hd_h_ch12.tab19_1_1_1_1 hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_h_ch12.tab19_1_1_2_2 hd_h_ch12.tab19_1_1_2_3 hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_h_ch12.tab19_1_1_2_5 hd_h_ch12.tab19_1_1_2_6" id="hd_b_ch12.tab19_1_1_14_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:middle;">Complications due to surgery to resolve mesh complications</th></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">134</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11.9</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">40</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">22.5</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fistula</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">15</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">6.7</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">123</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.8</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Infection</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">327</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11.9</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">40</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">7.5</td></tr><tr><td headers="hd_h_ch12.tab19_1_1_1_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wound complications</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_1 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_2 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_2 hd_h_ch12.tab19_1_1_2_3 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_4 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_5 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">40</td><td headers="hd_h_ch12.tab19_1_1_1_3 hd_h_ch12.tab19_1_1_2_6 hd_b_ch12.tab19_1_1_14_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.0</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Notes:</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="ch12.tab19_1"><p class="no_margin">includes mesh revision, partial mesh removal and complete mesh removal;</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="ch12.tab19_2"><p class="no_margin">management of mesh complications involves interventions other than surgery to amend or remove mesh;</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="ch12.tab19_3"><p class="no_margin">rate of outcome calculated as weighted average × 100.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12appatab1"><div id="ch12.appa.tab1" class="table"><h3><span class="label">Table 20</span><span class="title">Review protocol for management options for vaginal complications after mesh surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Field (based on <a href="http://www.prisma-statement.org/Extensions/Protocols.aspx" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-P</a></th><th id="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">What are the most effective management options for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women might present with vaginal infection, extrusion and/or erosion following mesh surgery. Currently, there is no consensus on how to manage these complications.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population/disease/condition/issue/domain</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Women (aged 18 years and over) who are experiencing vaginal complications after mesh surgery (both biological and synthetic materials) for UI, POP or both.</p>
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<p>Women having repeat surgery for UI or POP or both as well as women having repeat surgery for mesh complications or those who are treatment naïve will be included.</p>
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<p>Women presenting the following complications will be included:
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<ul id="ch12.l105"><li id="ch12.lt374" class="half_rhythm"><div>Mesh erosion (including exposure and extrusion)</div></li><li id="ch12.lt375" class="half_rhythm"><div>Mesh infection</div></li></ul></p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s)/exposure(s)/prognostic factor(s)</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The following management options will be considered:
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<ul id="ch12.l106"><li id="ch12.lt376" class="half_rhythm"><div>Mesh removal surgery (vaginal removal or trimming of mesh, abdominal/laparoscopic removal of mesh)</div></li><li id="ch12.lt377" class="half_rhythm"><div>Partial or complete mesh removal</div></li><li id="ch12.lt378" class="half_rhythm"><div>Vaginal oestrogen</div></li><li id="ch12.lt379" class="half_rhythm"><div>Antibiotics, systemic or local</div></li><li id="ch12.lt380" class="half_rhythm"><div>Drainage/collection of pus</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s)/control or reference (gold) standard</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l107"><li id="ch12.lt381" class="half_rhythm"><div>Mesh removal surgery vs. no surgery</div></li><li id="ch12.lt382" class="half_rhythm"><div>Mesh removal surgery vs. vaginal oestrogen</div></li><li id="ch12.lt383" class="half_rhythm"><div>Mesh removal surgery vs. antibiotics</div></li><li id="ch12.lt384" class="half_rhythm"><div>Vaginal oestrogen vs. nothing</div></li><li id="ch12.lt385" class="half_rhythm"><div>Partial removal of mesh vs. complete removal</div></li><li id="ch12.lt386" class="half_rhythm"><div>Drainage/collection of pus vs. nothing</div></li><li id="ch12.lt387" class="half_rhythm"><div>Drainage/collection of pus vs. antibiotics</div></li><li id="ch12.lt388" class="half_rhythm"><div>Drainage/collection of pus vs. removal of mesh</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul id="ch12.l108"><li id="ch12.lt389" class="half_rhythm"><div>Continued or repeated exposure/extrusion/infection</div></li><li id="ch12.lt390" class="half_rhythm"><div>Adverse events (immediate post-op or perioperative):
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<ul id="ch12.l109" class="circle"><li id="ch12.lt391" class="half_rhythm"><div>Severe bleeding requiring a blood transfusion</div></li><li id="ch12.lt392" class="half_rhythm"><div>Internal organ injury (to bladder or bowel)</div></li></ul></div></li><li id="ch12.lt393" class="half_rhythm"><div>Long-term complications (> 12 months):
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<ul id="ch12.l110" class="circle"><li id="ch12.lt394" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt395" class="half_rhythm"><div>Mesh erosion or extrusion</div></li><li id="ch12.lt396" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt397" class="half_rhythm"><div>Need for catheterisation</div></li><li id="ch12.lt398" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt399" class="half_rhythm"><div>De novo overactive bladder symptoms</div></li><li id="ch12.lt400" class="half_rhythm"><div>Sexual dysfunction</div></li><li id="ch12.lt401" class="half_rhythm"><div>Wound complications (infection and tissue breakdown)</div></li></ul>
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</div></li></ul>
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<b>Important</b>
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<ul id="ch12.l111"><li id="ch12.lt402" class="half_rhythm"><div>Health-related quality of life (validated scales only)</div></li><li id="ch12.lt403" class="half_rhythm"><div>Patient satisfaction
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<ul id="ch12.l112" class="circle"><li id="ch12.lt404" class="half_rhythm"><div>Patient reported improvement</div></li><li id="ch12.lt405" class="half_rhythm"><div>Patient Global Impression of Improvement</div></li></ul></div></li><li id="ch12.lt406" class="half_rhythm"><div>Repeat surgery (for mesh complications)</div></li><li id="ch12.lt407" class="half_rhythm"><div>Recurrence of urinary incontinence or prolapse</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Systematic reviews of randomised controlled trials (RCTs)</p>
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<p>RCTs</p>
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<p>Comparative cohort studies in the absence of other studies</p>
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<p>We will exclude conference abstracts (unless linked to an RCT)</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>No sample size restriction</p>
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<p>No date restriction</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity/sub-group analysis, or meta-regression</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Population subgroups:
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<ul id="ch12.l113"><li id="ch12.lt408" class="half_rhythm"><div>Type of initial surgery: POP vs. SUI</div></li></ul>
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Intervention subgroups:
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<ul id="ch12.l114"><li id="ch12.lt409" class="half_rhythm"><div>Type of surgical approach: laparoscopy vs. open</div></li><li id="ch12.lt410" class="half_rhythm"><div>Complete vs. partial mesh removal</div></li></ul>
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The committee will make special considerations for the following group when drafting their recommendations:
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<ul id="ch12.l115"><li id="ch12.lt411" class="half_rhythm"><div>Older women</div></li><li id="ch12.lt412" class="half_rhythm"><div>Women with physical disabilities</div></li><li id="ch12.lt413" class="half_rhythm"><div>Women with cognitive impairment</div></li><li id="ch12.lt414" class="half_rhythm"><div>Women who are considering future pregnancy</div></li></ul></p>
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</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening/selection/analysis</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Dual sifting will be undertaken for this question using NGA STAR software.</p>
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<p>Sifting, data extraction, appraisal of methodological quality and GRADE assessment will be performed by the systematic reviewer. Dual weeding will be performed by a second systematic reviewer on 5% or 10% of records (depending on database size), with resolution of discrepancies in discussion with the senior reviewer if necessary.</p>
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<p>Quality control will be performed by the senior systematic reviewer.</p>
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<p>Dual data extraction will not be performed for this question.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Pairwise meta-analyses, if possible, will be performed using Cochrane Review Manager (RevMan5).</p>
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<p>‘GRADEpro’ will be used to assess the quality of evidence for each outcome.</p>
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<p>NGA STAR software will be used for generating bibliographies/citations, study sifting, data extraction and recording quality assessment using checklists.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Sources to be searched: Medline, Medline In-Process, CCTR, CDSR, DARE, HTA, Embase</p>
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<p>Limits (e.g. date, study design):</p>
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<p>Apply standard animal/non-English language exclusion</p>
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<p>Limit to RCTs and systematic reviews in first instance but download all results</p>
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<p>Dates.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This review question is not an update.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Developer: The National Guideline Alliance</p>
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<p><a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10035" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10035</a>.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch12.appb">appendix B</a> of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms/duplicate</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome/study level</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Standard study checklists were used to critically appraise individual studies. Appraisal of methodological quality will be conducted using the appropriate tool:
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<ul id="ch12.l116"><li id="ch12.lt415" class="half_rhythm"><div>ROBIS (systematic reviews and meta-analyses),</div></li><li id="ch12.lt416" class="half_rhythm"><div>Cochrane risk of bias tool (RCTs).</div></li><li id="ch12.lt417" class="half_rhythm"><div>Cochrane risk of bias tool (Non-randomised studies)</div></li></ul>
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For further details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u></p>
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<p>The risk of bias across all available evidence was evaluated for each outcome using the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a>. Outcomes will be downgraded if the randomisation and/or concealment methods are unclear or inadequate. Outcomes will also be downgraded if there is considerable missing data (if there is a dropout of more than 20%, or if there is a difference of >20% between groups. Heterogeneity will be assessed using the i<sup>2</sup> statistic, outcomes will be downgraded once if i<sup>2</sup>≥50%, twice if i<sup>2</sup>≥80%.</p>
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<p>GRADE cannot be used for accurate assessment of bias for case series data and will not be used. Determining the quality of case series will include an assessment of bias, consecutive and comparative nature of series.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis (where suitable)</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the methods chapter of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>. If sufficient relevant RCT evidence is available, publication bias will be explored using RevMan software to examine funnel plots. Trial registries will be examined to identify missing evidence: <a href="http://Clinicaltrials.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Clinical trials.gov</a>, NIHR Clinical Trials Gateway</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Assessment of confidence in cumulative evidence</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale/context – Current management</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review in the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>A multidisciplinary committee <a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10035" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10035</a> developed the guideline. The committee was convened by the National Guideline Alliance and chaired by Dr Fergus Macbeth in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</p>
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<p>Staff from the National Guideline Alliance undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the guideline in collaboration with the committee. For details please see the methods chapter of the full guideline.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding/support</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds the National Guideline Alliance to develop guidelines for those working in the NHS, public health, and social care in England.</td></tr><tr><td headers="hd_h_ch12.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch12.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered with PROSPERO.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appatab2"><div id="ch12.appa.tab2" class="table"><h3><span class="label">Table 21</span><span class="title">Review protocol for management options for sexual dysfunction after mesh surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appa.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appa.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Field (based on <a href="http://www.prisma-statement.org/Extensions/Protocols.aspx" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-P</a></th><th id="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">What are the most effective management options for sexual dysfunction after mesh surgery?</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The objective of this review is to establish the most appropriate management of women with new or worsening sexual dysfunction after mesh surgery for SUI and/or POP. Sexual dysfunction in women is complex and multifactorial and the committee recognises that sexual dysfunction relating to mesh complications has a profound effect on sexual function, relationships and quality of life.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population/disease/condition/issue/domain</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Women (aged 18 years or older) experiencing new or worsening sexual dysfunction after mesh surgery for UI, POP or both.</p>
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<p>Women having repeat surgery or those who are treatment naïve will be included.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s)/exposure(s)/prognostic factor(s)</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l117"><li id="ch12.lt418" class="half_rhythm"><div>Mesh removal surgery</div></li><li id="ch12.lt419" class="half_rhythm"><div>Vaginal dilation</div></li><li id="ch12.lt420" class="half_rhythm"><div>Vaginal reconstruction/vaginaplasty</div></li><li id="ch12.lt421" class="half_rhythm"><div>Pain management for dyspareunia including psychosexual counselling, local anaesthetic, physiotherapy, systemic analgesics and botulinum toxin</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s)/control or reference (gold) standard</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l118"><li id="ch12.lt422" class="half_rhythm"><div>Comparison of vaginal oestrogen to any intervention listed above</div></li><li id="ch12.lt423" class="half_rhythm"><div>Comparison of all interventions vs. no treatment</div></li><li id="ch12.lt424" class="half_rhythm"><div>Comparison of any surgery vs. pain management</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p><b>Critical</b>
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<ul id="ch12.l119"><li id="ch12.lt425" class="half_rhythm"><div>Sexual function (measured using validated scales such as PISQ-IR or ePAQ)</div></li><li id="ch12.lt426" class="half_rhythm"><div>Adverse events (immediate post-op or perioperative):
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<ul id="ch12.l120" class="circle"><li id="ch12.lt427" class="half_rhythm"><div>Severe bleeding requiring blood transfusion</div></li><li id="ch12.lt428" class="half_rhythm"><div>Unintentional internal organ injury</div></li></ul></div></li><li id="ch12.lt429" class="half_rhythm"><div>Patient satisfaction
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<ul id="ch12.l121" class="circle"><li id="ch12.lt430" class="half_rhythm"><div>Patient reported improvement</div></li><li id="ch12.lt431" class="half_rhythm"><div>Patient Global Impression of Improvement</div></li></ul></div></li></ul>
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Justification: the committee is aware that removal of mesh is associated with risks including injury to surrounding structures and may not resolve the symptoms of sexual dysfunction and could worsen symptoms. As this question is related to sexual dysfunction, sexual function and patient satisfaction are critical outcomes.</p>
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<p><b>Important</b>
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<ul id="ch12.l122"><li id="ch12.lt432" class="half_rhythm"><div>Health-related quality of life</div></li><li id="ch12.lt433" class="half_rhythm"><div>Repeat surgery (for UI or POP, or mesh complications)</div></li><li id="ch12.lt434" class="half_rhythm"><div>Long-term complications (> 12 months):
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<ul id="ch12.l123" class="circle"><li id="ch12.lt435" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt436" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt437" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt438" class="half_rhythm"><div>Wound complications</div></li></ul></div></li><li id="ch12.lt439" class="half_rhythm"><div>Partner satisfaction</div></li></ul>
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Justification: Repeat surgery for mesh complications is common and carries potential for long-term adverse events, including recurrence of incontinence, prolapse and pain, including dyspareunia. The committee is aware that sexual dysfunction has major effects on overall quality of life and relationships.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>SR of RCT</p>
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<p>RCT</p>
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<p>If lack of full-text evidence, conference abstracts of RCTs will be considered.</p>
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<p>If lack of RCT evidence, comparative cohort studies will be considered.</p>
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<p>Case series will be considered if no comparative evidence is identified.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>No restriction on number for RCT</p>
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<p>Case series with a minimum of 50 participants</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity/sub-group analysis, or meta-regression</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population subgroups:
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<ul id="ch12.l124"><li id="ch12.lt440" class="half_rhythm"><div>Previous surgery for stress urinary incontinence vs. previous surgery for pelvic organ prolapse</div></li><li id="ch12.lt441" class="half_rhythm"><div>Abdominally placed mesh or vaginally placed mesh</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening/selection/analysis</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Sifting, data extraction, appraisal of methodological quality and GRADE assessment will be performed by the systematic reviewer. No dual weeding will be performed for this review questions.</p>
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<p>Quality control will be performed by the senior systematic reviewer.</p>
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<p>Dual data extraction will not be performed for this question.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Pairwise meta-analyses, if possible, will be performed using Cochrane Review Manager (RevMan5).</p>
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<p>‘GRADEpro’ will be used to assess the quality of evidence for each outcome.</p>
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<p>NGA STAR software will be used for generating bibliographies/citations, study sifting, data extraction and recording quality assessment using checklists.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Sources to be searched: Medline, Medline In-Process, CCTR, CDSR, DARE, HTA, Embase</p>
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<p>Limits (e.g. date, study design):</p>
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<p>Apply standard animal/non-English language exclusion</p>
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<p>Limit to RCTs and systematic reviews in first instance but download all results.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This review question is not an update.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Developer: The National Guideline Alliance</p>
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<p><a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10035" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10035</a>.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch12.appb">appendix B</a> of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms/duplicate</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome/study level</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Standard study checklists were used to critically appraise individual studies. Appraisal of methodological quality will be conducted using the appropriate tool:
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<ul id="ch12.l125"><li id="ch12.lt442" class="half_rhythm"><div>ROBIS (systematic reviews and meta-analyses),</div></li><li id="ch12.lt443" class="half_rhythm"><div>Cochrane risk of bias tool (RCTs).</div></li><li id="ch12.lt444" class="half_rhythm"><div>Cochrane risk of bias tool (Non-randomised studies)</div></li></ul>
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For further details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u></p>
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<p>The risk of bias across all available evidence was evaluated for each outcome using the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a>. Outcomes will be downgraded if the randomisation and/or concealment methods are unclear or inadequate. Outcomes will also be downgraded if there is considerable missing data (if there is a dropout of more than 20%, or if there is a difference of >20% between groups. Heterogeneity will be assessed using the i<sup>2</sup> statistic, outcomes will be downgraded once if i<sup>2</sup>≥50%, twice if i<sup>2</sup>≥80%.</p>
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<p>GRADE cannot be used for accurate assessment of bias for case series data and will not be used. Determining the quality of case series will include an assessment of bias, consecutive and comparative nature of series.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis (where suitable)</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the methods chapter of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>. If sufficient relevant RCT evidence is available, publication bias will be explored using RevMan software to examine funnel plots. Trial registries will be examined to identify missing evidence: <a href="http://Clinicaltrials.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Clinical trials.gov</a>, NIHR Clinical Trials Gateway</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Assessment of confidence in cumulative evidence</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale/context – Current management</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review in the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>A multidisciplinary committee developed the guideline. The committee was convened by the National Guideline Alliance and chaired by Dr Fergus Macbeth in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</p>
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<p>Staff from the National Guideline Alliance undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the guideline in collaboration with the committee. For details please see the methods chapter of the full guideline.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding/support</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds the National Guideline Alliance to develop guidelines for those working in the NHS, public health, and social care in England.</td></tr><tr><td headers="hd_h_ch12.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch12.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered with PROSPERO.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appatab3"><div id="ch12.appa.tab3" class="table"><h3><span class="label">Table 22</span><span class="title">Review protocol for management options for pain after mesh surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appa.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appa.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Field (based on <a href="http://www.prisma-statement.org/Extensions/Protocols.aspx" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-P</a>)</th><th id="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">What are the most effective management options for pain after mesh surgery?</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The objective of this review is to establish the most appropriate management of women experiencing pain following mesh surgery for SUI and/or POP.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population/disease/condition/issue/domain</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Women (aged 18 years or older) experiencing pain after mesh surgery for UI, POP or both.</p>
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<p>Women having repeat surgery or those who are treatment naïve will be included.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s)/exposure(s)/prognostic factor(s)</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l126"><li id="ch12.lt445" class="half_rhythm"><div>Mesh removal surgery (vaginal removal or trimming of mesh, abdominal/laparoscopic removal of mesh)</div></li><li id="ch12.lt446" class="half_rhythm"><div>Partial or complete mesh removal</div></li><li id="ch12.lt447" class="half_rhythm"><div>Vaginal oestrogen</div></li><li id="ch12.lt448" class="half_rhythm"><div>Antibiotics, systemic or local</div></li><li id="ch12.lt449" class="half_rhythm"><div>Drainage/collection of pus</div></li><li id="ch12.lt450" class="half_rhythm"><div>Pain management options</div></li><li id="ch12.lt451" class="half_rhythm"><div>Local anaesthetic</div></li><li id="ch12.lt452" class="half_rhythm"><div>Physiotherapy</div></li><li id="ch12.lt453" class="half_rhythm"><div>Systemic analgesics</div></li><li id="ch12.lt454" class="half_rhythm"><div>Botulinum toxin</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s)/control or reference (gold) standard</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l127"><li id="ch12.lt455" class="half_rhythm"><div>Vaginal oestrogen vs. mesh removal surgery</div></li><li id="ch12.lt456" class="half_rhythm"><div>Any intervention vs. no treatment</div></li><li id="ch12.lt457" class="half_rhythm"><div>Any surgery vs. pain management</div></li><li id="ch12.lt458" class="half_rhythm"><div>Drainage/collection of pus vs. antibiotics</div></li><li id="ch12.lt459" class="half_rhythm"><div>Drainage/collection of pus vs. mesh removal</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul id="ch12.l128"><li id="ch12.lt460" class="half_rhythm"><div>Pain (measured through a validated scale; appropriate MIDs to use if available will be identified through consultation with the GC)</div></li><li id="ch12.lt461" class="half_rhythm"><div>Patient satisfaction
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<ul id="ch12.l129" class="circle"><li id="ch12.lt462" class="half_rhythm"><div>Patient-reported improvement</div></li><li id="ch12.lt463" class="half_rhythm"><div>Patient Global Impression of Improvement</div></li></ul></div></li><li id="ch12.lt464" class="half_rhythm"><div>Adverse events (immediate post-op or perioperative):
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<ul id="ch12.l130" class="circle"><li id="ch12.lt465" class="half_rhythm"><div>Severe bleeding requiring blood transfusion</div></li><li id="ch12.lt466" class="half_rhythm"><div>Unintentional internal organ injury</div></li></ul></div></li></ul>
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<b>Important</b>
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<ul id="ch12.l131"><li id="ch12.lt467" class="half_rhythm"><div>Health-related quality of life</div></li><li id="ch12.lt468" class="half_rhythm"><div>Repeat surgery (for UI or POP, or mesh complications)</div></li><li id="ch12.lt469" class="half_rhythm"><div>Long-term complications (> 12 months)
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<ul id="ch12.l132" class="circle"><li id="ch12.lt470" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt471" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt472" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt473" class="half_rhythm"><div>Would complications</div></li><li id="ch12.lt474" class="half_rhythm"><div>Mesh erosion or extrusion</div></li><li id="ch12.lt475" class="half_rhythm"><div>De novo overactive bladder symptoms</div></li><li id="ch12.lt476" class="half_rhythm"><div>Sexual dysfunction</div></li><li id="ch12.lt477" class="half_rhythm"><div>Need for catheterisation</div></li></ul></div></li><li id="ch12.lt478" class="half_rhythm"><div>Recurrence of urinary incontinence or prolapse</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>SR of RCT</p>
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<p>RCTs</p>
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<p>If lack of full-text evidence, conference abstracts of RCTs will be considered.</p>
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<p>If lack of RCT evidence, comparative cohort studies will be considered.</p>
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<p>Case series studies ≥50 will also be considered if no comparative evidence is identified.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity/sub-group analysis, or meta-regression</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population subgroups:
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<ul id="ch12.l133"><li id="ch12.lt479" class="half_rhythm"><div>Type of previous surgery (POP, SUI, or both)</div></li><li id="ch12.lt480" class="half_rhythm"><div>Location of mesh (abdominally-placed, vaginally-placed)</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening/selection/analysis</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Sifting, data extraction, appraisal of methodological quality and GRADE assessment will be performed by the systematic reviewer. No dual weeding will be performed for this review questions.</p>
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<p>Quality control will be performed by the senior systematic reviewer.</p>
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<p>Dual data extraction will not be performed for this question.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Pairwise meta-analyses, if possible, will be performed using Cochrane Review Manager (RevMan5).</p>
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<p>‘GRADEpro’ will be used to assess the quality of evidence for each outcome.</p>
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<p>NGA STAR software will be used for generating bibliographies/citations, study sifting, data extraction and recording quality assessment using checklists.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Sources to be searched: Medline, Medline In-Process, CCTR, CDSR, DARE, HTA, Embase</p>
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<p>Limits (e.g. date, study design):</p>
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<p>Apply standard animal/non-English language exclusion</p>
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<p>Limit to RCTs and systematic reviews in first instance but download all results</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This review question is not an update.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Developer: The National Guideline Alliance</p>
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<p><a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10035" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10035</a>.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch12.appb">appendix B</a> of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms/duplicate</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome/study level</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Standard study checklists were used to critically appraise individual studies. Appraisal of methodological quality will be conducted using the appropriate tool:
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<ul id="ch12.l134"><li id="ch12.lt481" class="half_rhythm"><div>ROBIS (systematic reviews and meta-analyses),</div></li><li id="ch12.lt482" class="half_rhythm"><div>Cochrane risk of bias tool (RCTs).</div></li><li id="ch12.lt483" class="half_rhythm"><div>Cochrane risk of bias tool (Non-randomised studies)</div></li></ul>
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For further details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u></p>
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<p>The risk of bias across all available evidence was evaluated for each outcome using the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a>. Outcomes will be downgraded if the randomisation and/or concealment methods are unclear or inadequate. Outcomes will also be downgraded if there is considerable missing data (if there is a dropout of more than 20%, or if there is a difference of >20% between groups. Heterogeneity will be assessed using the i<sup>2</sup> statistic, outcomes will be downgraded once if i<sup>2</sup>≥50%, twice if i<sup>2</sup>≥80%.</p>
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<p>GRADE cannot be used for accurate assessment of bias for case series data and will not be used. Determining the quality of case series will include an assessment of bias, consecutive and comparative nature of series.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis (where suitable)</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the methods chapter of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>. If sufficient relevant RCT evidence is available, publication bias will be explored using RevMan software to examine funnel plots. Trial registries will be examined to identify missing evidence: <a href="http://Clinicaltrials.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Clinical trials.gov</a>, NIHR Clinical Trials Gateway</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Assessment of confidence in cumulative evidence</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale/context – Current management</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review in the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>A multidisciplinary committee developed the guideline. The committee was convened by the National Guideline Alliance by Dr Fergus Macbeth in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</p>
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<p>Staff from the National Guideline Alliance undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the guideline in collaboration with the committee. For details please see the methods chapter of the full guideline.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding/support</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians & Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians & Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds the National Guideline Alliance to develop guidelines for those working in the NHS, public health, and social care in England.</td></tr><tr><td headers="hd_h_ch12.appa.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch12.appa.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered with PROSPERO.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appatab4"><div id="ch12.appa.tab4" class="table"><h3><span class="label">Table 23</span><span class="title">Review protocol for management options for urinary complications after mesh surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appa.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appa.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Field (based on <a href="http://www.prisma-statement.org/Extensions/Protocols.aspx" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-P</a></th><th id="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">What are the most effective management options for urinary complications after mesh surgery?</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">What is the best way of managing women who have problems with urinary complications following mesh surgery? These are new complications and therefore there is no current standard: it is important to know who and how this should be managed.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population/disease/condition/issue/do main</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women (aged 18 years and over) experiencing any of the following urinary complications after mesh surgery (both biological and synthetic materials) for UI, POP or both:
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<ul id="ch12.l135"><li id="ch12.lt484" class="half_rhythm"><div>Bladder perforation or mesh in bladder</div></li><li id="ch12.lt485" class="half_rhythm"><div>Urinary retention</div></li><li id="ch12.lt486" class="half_rhythm"><div>Voiding difficulties</div></li><li id="ch12.lt487" class="half_rhythm"><div>Lower urinary tract infection including mesh in urethra</div></li><li id="ch12.lt488" class="half_rhythm"><div>Ureteric or upper urinary tract complication</div></li><li id="ch12.lt489" class="half_rhythm"><div>Fistula: vesicovaginal, urethra-vaginal, or urinary</div></li></ul>
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Women having repeat surgery or those who are treatment naïve will be included.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s)/exposure(s)/prognostic factor(s)</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch12.l136"><li id="ch12.lt490" class="half_rhythm"><div>Mesh removal surgery, including laser and abdominal (including laparoscopic) surgery</div></li><li id="ch12.lt491" class="half_rhythm"><div>Transurethral excision</div></li><li id="ch12.lt492" class="half_rhythm"><div>Vaginal approach to mesh excision</div></li><li id="ch12.lt493" class="half_rhythm"><div>Division of tape/mesh</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s)/control or reference (gold) standard</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mesh removal surgery vs. no surgery
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<ul id="ch12.l137"><li id="ch12.lt494" class="half_rhythm"><div>Urethra: mesh removal vs. no removal</div></li><li id="ch12.lt495" class="half_rhythm"><div>Transurethral excision vs. vaginal open excision of urethral mesh</div></li><li id="ch12.lt496" class="half_rhythm"><div>Transurethral Laser vs. Transurethral excision</div></li><li id="ch12.lt497" class="half_rhythm"><div>Transurethral laser vs. Vaginal open excision of urethral mesh</div></li><li id="ch12.lt498" class="half_rhythm"><div>Bladder: transurethral laser vs. abdominal (including laparoscopic) removal of bladder mesh</div></li><li id="ch12.lt499" class="half_rhythm"><div>Mesh division (urethrolysis) vs. no surgery</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul id="ch12.l138"><li id="ch12.lt500" class="half_rhythm"><div>Continued or repeated urinary complications (as per above including mesh)</div></li><li id="ch12.lt501" class="half_rhythm"><div>Adverse events (immediate post-op or perioperative):
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<ul id="ch12.l139" class="circle"><li id="ch12.lt502" class="half_rhythm"><div>Severe bleeding requiring a blood transfusion</div></li><li id="ch12.lt503" class="half_rhythm"><div>Unintentional Internal organ injury (bladder or bowel or ureter)</div></li></ul></div></li><li id="ch12.lt504" class="half_rhythm"><div>Long-term complications (> 12 months):
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<ul id="ch12.l140" class="circle"><li id="ch12.lt505" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt506" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt507" class="half_rhythm"><div>Need for catheterisation</div></li><li id="ch12.lt508" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt509" class="half_rhythm"><div>De novo overactive bladder symptoms</div></li><li id="ch12.lt510" class="half_rhythm"><div>Wound complications</div></li><li id="ch12.lt511" class="half_rhythm"><div>Urinary incontinence</div></li></ul></div></li></ul>
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<b>Important</b>
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<ul id="ch12.l141"><li id="ch12.lt512" class="half_rhythm"><div>Continence specific health-related quality of life:
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<ul id="ch12.l142" class="circle"><li id="ch12.lt513" class="half_rhythm"><div>ICIQ</div></li><li id="ch12.lt514" class="half_rhythm"><div>BFLUTS</div></li><li id="ch12.lt515" class="half_rhythm"><div>i-QOL</div></li><li id="ch12.lt516" class="half_rhythm"><div>SUIQQ</div></li><li id="ch12.lt517" class="half_rhythm"><div>UISS</div></li><li id="ch12.lt518" class="half_rhythm"><div>SEAPI-QMM,</div></li><li id="ch12.lt519" class="half_rhythm"><div>ISI</div></li><li id="ch12.lt520" class="half_rhythm"><div>KHQ</div></li><li id="ch12.lt521" class="half_rhythm"><div>E-PAQ</div></li></ul></div></li><li id="ch12.lt522" class="half_rhythm"><div>Patient satisfaction
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<ul id="ch12.l143" class="circle"><li id="ch12.lt523" class="half_rhythm"><div>Patient reported improvement</div></li><li id="ch12.lt524" class="half_rhythm"><div>Patient Global Impression of Improvement</div></li></ul></div></li><li id="ch12.lt525" class="half_rhythm"><div>Repeat surgery (for UI or POP, or mesh complications)</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Systematic reviews of randomised controlled trials (RCTs)</p>
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<p>RCTs</p>
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<p>Comparative cohort studies in the absence of other studies</p>
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<p>Case series/expert opinion in the absence of other studies</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>20 minimum number</p>
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<p>50 minimum for case series</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity/sub-group analysis, or meta-regression</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population subgroups:
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<ul id="ch12.l144"><li id="ch12.lt526" class="half_rhythm"><div>Type of previous surgery e.g. POP vs. SUI</div></li></ul>
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Intervention subgroups:
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<ul id="ch12.l145"><li id="ch12.lt527" class="half_rhythm"><div>Type of surgical approach: e.g. laparoscopy vs. open</div></li><li id="ch12.lt528" class="half_rhythm"><div>Complete vs. partial mesh removal</div></li><li id="ch12.lt529" class="half_rhythm"><div>The committee will make special considerations for the following groups when drafting their recommendations Older women</div></li><li id="ch12.lt530" class="half_rhythm"><div>Women with physical disabilities</div></li><li id="ch12.lt531" class="half_rhythm"><div>Women with cognitive impairment</div></li><li id="ch12.lt532" class="half_rhythm"><div>Women who are considering future pregnancy</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening/selection/analysis</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Dual sifting will be undertaken for this question using NGA STAR software.</p>
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<p>Sifting, data extraction, appraisal of methodological quality and GRADE assessment will be performed by the systematic reviewer. Dual weeding will be performed by a second systematic reviewer on 5% or 10% of records (depending on database size), with resolution of discrepancies in discussion with the senior reviewer if necessary. Quality control will be performed by the senior systematic reviewer.</p>
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<p>Dual data extraction will not be performed for this question.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Pairwise meta-analyses, if possible, will be performed using Cochrane Review Manager (RevMan5).</p>
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<p>‘GRADEpro’ will be used to assess the quality of evidence for each outcome.</p>
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<p>NGA STAR software will be used for generating bibliographies/citations, study sifting, data extraction and recording quality assessment using checklists.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Sources to be searched: Medline, Medline In-Process, CCTR, CDSR, DARE, HTA, Embase</p>
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<p>Limits (e.g. date, study design):</p>
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<p>Apply standard animal/non-English language exclusion</p>
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<p>Limit to RCTs and systematic reviews in first instance but download all results</p>
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<p>No date restrictions will be applied.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This review question is not an update.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Developer: The National Guideline Alliance</p>
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<p><a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10035" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10035</a>.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch12.appb">appendix B</a> of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms/duplicate</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome/study level</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Standard study checklists were used to critically appraise individual studies. Appraisal of methodological quality will be conducted using the appropriate tool:
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<ul id="ch12.l146"><li id="ch12.lt533" class="half_rhythm"><div>ROBIS (systematic reviews and meta-analyses),</div></li><li id="ch12.lt534" class="half_rhythm"><div>Cochrane risk of bias tool (RCTs).</div></li><li id="ch12.lt535" class="half_rhythm"><div>Cochrane risk of bias tool (Non-randomised studies)</div></li></ul>
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For further details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u></p>
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<p>The risk of bias across all available evidence was evaluated for each outcome using the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a>. Outcomes will be downgraded if the randomisation and/or concealment methods are unclear or inadequate. Outcomes will also be downgraded if there is considerable missing data (if there is a dropout of more than 20%, or if there is a difference of >20% between groups. Heterogeneity will be assessed using the i<sup>2</sup> statistic, outcomes will be downgraded once if i<sup>2</sup>≥50%, twice if i<sup>2</sup>≥80%.</p>
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<p>GRADE cannot be used for accurate assessment of bias for case series data and will not be used. Determining the quality of case series will include an assessment of bias, consecutive and comparative nature of series.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis (where suitable)</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the methods chapter of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>. If sufficient relevant RCT evidence is available, publication bias will be explored using RevMan software to examine funnel plots. Trial registries will be examined to identify missing evidence: <a href="http://Clinicaltrials.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Clinical trials.gov</a>, NIHR Clinical Trials Gateway</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Assessment of confidence in cumulative evidence</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</p>
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<p>Explain rationale and alternative methods if not using GRADE approach</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale/context – Current management</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review in the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>A multidisciplinary committee developed the guideline. The committee was convened by the National Guideline Alliance and chaired by Dr Fergus Macbeth in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</p>
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<p>Staff from the National Guideline Alliance undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the guideline in collaboration with the committee. For details please see the methods chapter of the full guideline.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding/support</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians and Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds the National Guideline Alliance to develop guidelines for those working in the NHS, public health, and social care in England.</td></tr><tr><td headers="hd_h_ch12.appa.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch12.appa.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered with PROSPERO.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appatab5"><div id="ch12.appa.tab5" class="table"><h3><span class="label">Table 24</span><span class="title">Review protocol for management options for bowel symptoms after mesh surgery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appa.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appa.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Field (based on <a href="http://www.prisma-statement.org/Extensions/Protocols.aspx" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-P</a></th><th id="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">What are the most effective management options for bowel symptoms after mesh surgery?</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The objective of this review is to establish the most appropriate management strategy of women with bowel symptoms following mesh surgery.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population/disease/condition/issue/domain</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Women (aged 18 years or older) experiencing bowel complications after mesh surgery for UI, POP or both.</p>
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<p>Both functional complications (directly related to bowel action) and non-functional complications (not directly related to action of bowel, but occurring in the location of the bowel) will be included.</p>
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<p>Women with any of the following bowel complications will be considered:</p>
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<p><b>Non-functional</b>
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<ul id="ch12.l147"><li id="ch12.lt536" class="half_rhythm"><div>Mesh erosion presented as: fever, malaise, pelvic pain, mucous or bloody discharge per rectum</div></li><li id="ch12.lt537" class="half_rhythm"><div>Bowel stricture</div></li><li id="ch12.lt538" class="half_rhythm"><div>Bowel fistulation</div></li></ul>
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<b>Functional</b>
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<ul id="ch12.l148"><li id="ch12.lt539" class="half_rhythm"><div>Obstructed defecation</div></li><li id="ch12.lt540" class="half_rhythm"><div>Faecal incontinence</div></li></ul></p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s)/exposure(s)/prognostic factor(s)</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For non-functional complications:
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<ul id="ch12.l149"><li id="ch12.lt541" class="half_rhythm"><div>Mesh removal (vaginal or abdominal)</div></li><li id="ch12.lt542" class="half_rhythm"><div>Resection</div></li><li id="ch12.lt543" class="half_rhythm"><div>Re-anastomosis</div></li><li id="ch12.lt544" class="half_rhythm"><div>Stoma</div></li></ul>
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For functional complications:
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<ul id="ch12.l150"><li id="ch12.lt545" class="half_rhythm"><div>Laxatives and aperients</div></li><li id="ch12.lt546" class="half_rhythm"><div>Lifestyle modifications: diet, exercise, weight loss</div></li><li id="ch12.lt547" class="half_rhythm"><div>Biofeedback</div></li><li id="ch12.lt548" class="half_rhythm"><div>Complex targeted laxatives: prucalopride, linaclotide</div></li><li id="ch12.lt549" class="half_rhythm"><div>Rectal irrigation</div></li><li id="ch12.lt550" class="half_rhythm"><div>Sacral nerve stimulation</div></li><li id="ch12.lt551" class="half_rhythm"><div>Laparoscopic ventral mesh rectopexy</div></li><li id="ch12.lt552" class="half_rhythm"><div>Stapled Transanal Resection of the Rectum (STARR)</div></li><li id="ch12.lt553" class="half_rhythm"><div>Stoma/Antegrade Colonic Enema (ACE)</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s)/control or reference (gold) standard</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Each management option against each other, separated according to the type of complication: non-functional or functional)</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p><b>Critical</b>
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<ul id="ch12.l151"><li id="ch12.lt554" class="half_rhythm"><div>Reduction in bowel symptoms</div></li><li id="ch12.lt555" class="half_rhythm"><div>Adverse events (immediate post-operative or peri-operative:
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<ul id="ch12.l152" class="circle"><li id="ch12.lt556" class="half_rhythm"><div>Severe bleeding requiring blood transfusion</div></li><li id="ch12.lt557" class="half_rhythm"><div>Unintentional internal organ injury</div></li></ul></div></li><li id="ch12.lt558" class="half_rhythm"><div>Health-related quality of life</div></li></ul>
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Justification: Bowel symptoms can be a significant problem in women undergoing mesh surgery, interfering with quality of life and functionality, employability, mental health and relationships. In addition, surgical interventions to remove mesh are associated with significant risks and morbidity, and is therefore crucial for healthcare practitioners to be able to counsel service users adequately.</p>
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<p><b>Important</b>
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<ul id="ch12.l153"><li id="ch12.lt559" class="half_rhythm"><div>Complications (more than 12 months):
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<ul id="ch12.l154" class="circle"><li id="ch12.lt560" class="half_rhythm"><div>Pain</div></li><li id="ch12.lt561" class="half_rhythm"><div>Fistula</div></li><li id="ch12.lt562" class="half_rhythm"><div>Infection</div></li><li id="ch12.lt563" class="half_rhythm"><div>Wound complications</div></li><li id="ch12.lt564" class="half_rhythm"><div>Mesh erosion or extrusion</div></li><li id="ch12.lt565" class="half_rhythm"><div>Sexual dysfunction</div></li></ul></div></li><li id="ch12.lt566" class="half_rhythm"><div>Patient satisfaction</div></li><li id="ch12.lt567" class="half_rhythm"><div>Repeat surgery for UI, POP or mesh complications</div></li><li id="ch12.lt568" class="half_rhythm"><div>Recurrence of urinary incontinence or prolapse</div></li></ul>
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Complications will be stratified as follows:
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<ul id="ch12.l155"><li id="ch12.lt569" class="half_rhythm"><div>Short-term: complications occurring after one year or less (≤ 1 year)</div></li><li id="ch12.lt570" class="half_rhythm"><div>Medium-term: complications occurring after one year and up to five years (> 1 year and ≤ 5 years)</div></li><li id="ch12.lt571" class="half_rhythm"><div>Long-term: complications occurring after 5 years (> 5 years)</div></li></ul></p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>For all outcomes SR of RCTs and RCTs will be considered.</p>
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<p>If lack of full-text evidence, conference abstracts of RCTs will be considered. If lack of RCT evidence, comparative cohort studies will be considered.</p>
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<p>For complications, RCTs will be considered. In the absence of RCT evidence, prospective and retrospective studies will be considered. In the absence of the prospective or retrospective data, case series will be considered.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>No number restriction for RCT</p>
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<p>For case series, minimum 50 participants</p>
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<p>No date restriction</p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity/sub-group analysis, or meta-regression</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population subgroups:
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<ul id="ch12.l156"><li id="ch12.lt572" class="half_rhythm"><div>Type of initial surgery: POP vs. SUI</div></li></ul>
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Intervention subgroups:
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<ul id="ch12.l157"><li id="ch12.lt573" class="half_rhythm"><div>Type of surgical approach:
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<ul id="ch12.l158" class="circle"><li id="ch12.lt574" class="half_rhythm"><div>laparoscopy vs. open</div></li><li id="ch12.lt575" class="half_rhythm"><div>Complete vs. partial mesh removal</div></li></ul></div></li></ul>
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The committee will make special considerations for the following group when drafting their recommendations:
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<ul id="ch12.l159"><li id="ch12.lt576" class="half_rhythm"><div>Older women</div></li><li id="ch12.lt577" class="half_rhythm"><div>Women with physical disabilities</div></li><li id="ch12.lt578" class="half_rhythm"><div>Women with cognitive impairment</div></li><li id="ch12.lt579" class="half_rhythm"><div>Women who are considering future pregnancy</div></li></ul></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening/selection/analysis</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Studies will be imported to the NGA STAR database for screening by one reviewer. A random sample of the references will be sifted by a second reviewer. This sample size will be 10% of the total, or 100 studies if the search identifies fewer than 1000 studies. All disagreements will be resolved by discussion between the two reviewers. The senior systematic reviewer or guideline lead will act as arbiter where necessary.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Pairwise meta-analyses, if possible, will be performed using Cochrane Review Manager (RevMan5).</p>
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<p>‘GRADEpro’ will be used to assess the quality of evidence for each outcome.</p>
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<p>NGA STAR software will be used for generating bibliographies/citations, study sifting, data extraction and recording quality assessment using checklists.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>A search strategy will be developed to include medical subject headings and free text terms based on the eligibility criteria. Medline In-Process, CCTR, CDSR, DARE, HTA and Embase databases will be searched</p>
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<p>The search will be limited to human studies and those conducted in the English language.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This is a new area of the guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Developer: The National Guideline Alliance</p>
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<p><a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10035" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/indevelopment/gid-ng10035</a>.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 4.5 of <a href="https://www.nice.org.uk/article/pmg20/chapter/4-Developing-review-questions-and-planning-the-evidence-review#planning-the-evidence-review" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch12.appb">appendix B</a> of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms/duplicate</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as <a href="#ch12.appb">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch12.appd">appendix D</a> (clinical evidence tables) or <a href="#ch12.apph">H</a> (economic evidence tables) of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome/study level</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Standard study checklists were used to critically appraise individual studies. Appraisal of methodological quality will be conducted using the appropriate tool:
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<ul id="ch12.l160"><li id="ch12.lt580" class="half_rhythm"><div>ROBIS (systematic reviews and meta-analyses),</div></li><li id="ch12.lt581" class="half_rhythm"><div>Cochrane risk of bias tool (RCTs).</div></li><li id="ch12.lt582" class="half_rhythm"><div>Cochrane risk of bias tool (Non-randomised studies)</div></li></ul>
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For further details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u></p>
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<p>The risk of bias across all available evidence was evaluated for each outcome using the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.gradeworkinggroup.org/</a>. Outcomes will be downgraded if the randomisation and/or concealment methods are unclear or inadequate. Outcomes will also be downgraded if there is considerable missing data (if there is a dropout of more than 20%, or if there is a difference of >20% between groups. Heterogeneity will be assessed using the i<sup>2</sup> statistic, outcomes will be downgraded once if i<sup>2</sup>≥50%, twice if i<sup>2</sup>≥80%.</p>
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<p>GRADE cannot be used for accurate assessment of bias for case series data and will not be used. Determining the quality of case series will include an assessment of bias, consecutive and comparative nature of series.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the methods chapter of the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>. If sufficient relevant RCT evidence is available, publication bias will be explored using RevMan software to examine funnel plots. Trial registries will be examined to identify missing evidence: <a href="http://Clinicaltrials.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Clinical trials.gov</a>, NIHR Clinical Trials Gateway</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Confidence in cumulative evidence</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>
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<u>2014</u>.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale/context – Current management</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review in the full guideline.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>A multidisciplinary committee developed the guideline. The committee was convened by the National Guideline Alliance by Dr Fergus Macbeth in line with section 3 of Developing NICE guidelines: the manual.</p>
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<p>Staff from the National Guideline Alliance undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the guideline in collaboration with the committee. For details please see the methods chapter of the full guideline.</p></td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding/support</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians & Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The National Guideline Alliance is funded by NICE and hosted by the Royal College of Obstetricians & Gynaecologists.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds the National Guideline Alliance to develop guidelines for those working in the NHS, public health, and social care in England.</td></tr><tr><td headers="hd_h_ch12.appa.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch12.appa.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered with PROSPERO.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab1"><div id="ch12.appb.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Pelvic Organ Prolapse/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp pelvic organ prolapse/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic$ adj3 organ$ adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary adj3 bladder adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin$ or urogenital$ or genit$ or uter$ or viscer$ or anterior$ or posterior$ or apical or pelvi$ or vault$ or urethr$ or bladder$) adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos$ or visceroptos$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rectocele/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">rectocele/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia$ adj3 (pelvi$ or vagin$ or urogenital$ or uter$ or bladder$ or urethr$ or viscer$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethroc?ele$ or enteroc?ele$ or sigmoidoc?ele$ or proctoc?ele$ or rectoc?ele$ or cystoc?ele$ or rectoenteroc?ele$ or cystourethroc?ele$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–10</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary Incontinence, Stress/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stress Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mixed Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine adj2 (loss or leak$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress$ or mix$ or effort$) adj5 incontinen$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/12–17</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary Incontinence/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">urine incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urin$ adj5 incontinen$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">UI.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/19–22</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Surgical Mesh/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp surgical mesh/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh$ or non-mesh$ or nonmesh$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*“Prostheses and Implants”/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*implant/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Biocompatible Materials/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*biomaterial/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog$ or synthetic$) adj implant$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/24–31</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Estrogens/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Estrogen Antagonists/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“Estrogens, Conjugated (USP)”/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Estradiol/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Estriol/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Estrone/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp estrogen/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp antiestrogen/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">conjugated estrogen/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">estradiol/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">estriol/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">estrone/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(oestrogen$ or estrogen$ or oestradiol$ or estradiol$ or oestriol$ or estriol$ or oestron$ or estron$ or Vagiferm$ or estring$ or e-string$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44 or 45</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Minimally Invasive Surgical Procedures/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp minimally invasive procedure/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(minimally adj invasive adj3 (surg$ or resect$ or approach$ or technique$ or treatment$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mesh$ or tape$ or sling$ or TVT$) adj5 (remov$ or extract$ excis$ or revis$ or repair$ or resect$ or division$ or trim$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(trim$ adj5 (mesh$ or tape$ or sling$ or TVT$ or flap$ or in-office$ or office$ or clinic$ or outpatient$ or vagin$ or extru$ or expos$ or erosion$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(remov$ adj5 (mesh$ or tape$ or sling$ or TVT$ or flap$ or implant$ or prosthes$ or graft$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin$ adj3 excis$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((pus$ or absess$ or wound$) adj5 drain$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47 or 48 or 49 or 50 or 51 or 52 or 53 or 54</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anti-Bacterial Agents/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">antibiotic agent/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(anti-biotic$ or antibiotic$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56 or 57 or 58</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 or 18</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46 or 59</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 and 60 and 61</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47 or 48 or 49 or 53</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 and 60 and 63</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50 or 51 or 52 or 54</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60 and 65</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62 or 64 or 66</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">remove duplicates from 67</td></tr><tr><td headers="hd_h_ch12.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69</td><td headers="hd_h_ch12.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 68 to english language [general exclusions filter applied]</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab2"><div id="ch12.appb.tab2" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Pelvic Organ Prolapse] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic* near/3 organ* near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary near/3 bladder near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin* or urogenital* or genit* or uter* or viscer* or anterior* or posterior* or apical or pelvi* or vault* or urethr* or bladder*) near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos* or visceroptos*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Rectocele] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia* near/3 (pelvi* or vagin* or urogenital* or uter* or bladder* or urethr* or viscer*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethrocele* or urethrocoele* or enterocele* or enterocoele* or sigmoidocoele* or sigmoidocele* or proctocele* or proctocoele* or rectocele* or rectocoele* or cystocele* or cystocoele* or rectoenterocele* or rectoenterocoele* or cystourethrocele* or cystourethrocoele*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Urinary Incontinence, Stress] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine near/2 (loss or leak*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress* or mix* or effort*) near/5 incontinen*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10 or #11 or #12 or #13</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Surgical Mesh] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh* or non-mesh* or nonmesh*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Prostheses and Implants] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Biocompatible Materials] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog* or synthetic*) next implant*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15 or #16 or #17 or #18 or #19</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrogens] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrogen Antagonists] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrogens, Conjugated (USP)] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estradiol] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estriol] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrone] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(oestrogen* or estrogen* or oestradiol* or estradiol* or oestriol* or estriol* or oestron* or estron* or Vagiferm* or estring* or e-string*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Anti-Bacterial Agents] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#29</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(anti-biotic* or antibiotic*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#30</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Minimally Invasive Surgical Procedures] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#31</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(minimally next invasive near/3 (surg* or resect* or approach* or technique* or treatment*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#32</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin* near/3 excis*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#33</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mesh* or tape* or sling* or TVT*) near/5 (remov* or extract* excis* or revis* or repair* or resect* or division* or trim*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#35</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(trim* near/5 (mesh* or tape* or sling* or TVT* or flap* or in-office* or office* or clinic* or outpatient* or vagin* or extru* or expos* or erosion*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#36</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(remov* near/5 (mesh* or tape* or sling* or TVT* or flap* or implant* or prosthes* or graft*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((pus* or absess* or wound*) near/5 drain*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34 or #35 or #36 or #37</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#39</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9 or #14</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#40</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20 and #33 and #39</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#41</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38 and #39</td></tr><tr><td headers="hd_h_ch12.appb.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#42</td><td headers="hd_h_ch12.appb.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#40 or #41</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab3"><div id="ch12.appb.tab3" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Pelvic Organ Prolapse/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp pelvic organ prolapse/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic$ adj3 organ$ adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary adj3 bladder adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin$ or urogenital$ or genit$ or uter$ or viscer$ or anterior$ or posterior$ or apical or pelvi$ or vault$ or urethr$ or bladder$) adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos$ or visceroptos$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rectocele/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">rectocele/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia$ adj3 (pelvi$ or vagin$ or urogenital$ or uter$ or bladder$ or urethr$ or viscer$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethroc?ele$ or enteroc?ele$ or sigmoidoc?ele$ or proctoc?ele$ or rectoc?ele$ or cystoc?ele$ or rectoenteroc?ele$ or cystourethroc?ele$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–10</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary Incontinence, Stress/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stress Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mixed Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine adj2 (loss or leak$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress$ or mix$ or effort$) adj5 incontinen$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/12–17</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary Incontinence/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">urine incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urin$ adj5 incontinen$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">UI.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/19–22</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Surgical Mesh/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp surgical mesh/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh$ or non-mesh$ or nonmesh$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*“Prostheses and Implants”/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*implant/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Biocompatible Materials/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*biomaterial/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog$ or synthetic$) adj implant$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/24–31</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Minimally Invasive Surgical Procedures/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp minimally invasive procedure/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(minimally adj invasive adj3 (surg$ or resect$ or approach$ or technique$ or treatment$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mesh$ or tape$ or sling$) adj3 (remov$ or excis$ or revis$ or repair$ or resect$ or division$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">urethrolysis$.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(transurethral$ adj3 (excis$ or approach$ or technique$ or cystoscop$ or laser$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((laparoscopic$ or robotic$ or laser$) adj3 (excis$ or approach$ or technique$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin$ adj3 excis$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((retropubic or suprapubic) adj3 dissect$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Natural Orifice Endoscopic Surgery/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">endoscopic surgery/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">scissors/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((endoscop$ or cystoscop$ or hysteroscop$) adj3 (scissor$ or grasper$ or forcep$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((complete$ or whole or wholly or partial$) adj3 excis$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Estrogens/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Estrogen Antagonists/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“Estrogens, Conjugated (USP)”/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Estradiol/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Estriol/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Estrone/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp estrogen/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp antiestrogen/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">conjugated estrogen/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">estradiol/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">estriol/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">estrone/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(oestrogen$ or estrogen$ or oestradiol$ or estradiol$ or oestriol$ or estriol$ or oestron$ or estron$ or Vagiferm$ or estring$ or e-string$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain Management/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anesthetics, Local/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Analgesia/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Counseling/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Physical Therapy Modalities/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">local anesthetic agent/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">analgesia/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">counseling/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp physiotherapy/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pain adj5 (manag$ or therap$ or treatment$ or control$)).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(anaesthetic$ or anesthetic$ or analges$).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((psycho-sex$ or psychosex$ or sex$) adj5 counsel$).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">physiotherap$.mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Botulinum Toxins/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp botulinum toxin/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp botulinum toxin A/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">botulinum$.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(botul$ adj2 tox$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(BTA or BTX or CNBTX or BoNT$ or BoTx).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(botox or dysport or azzalure or oculinum or prosigne or purtox or vistabel or xeomin or bocouture or myobloc or rimabotulinum$ or abobotuli$ or onabotulinum$ or Neuronox or Meditoxin).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Reconstructive Surgical Procedures/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">81</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">vagina reconstruction/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin$ adj5 reconstruct$).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">vaginoplast$.mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dilatation/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">85</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">vaginal dilator/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">86</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin$ adj5 dilat$).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">87</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57 or 58 or 59 or 60 or 61 or 62 or 63 or 64 or 65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85 or 86</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sexual Dysfunction, Physiological/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">89</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sexual Dysfunctions, Psychological/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">sexual dysfunction/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dyspareunia/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">92</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dyspareunia/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">93</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sexual$ adj5 (dysfunct$ or problem$ or symptom$)).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">94</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((sex$ or intercourse) adj5 pain$).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">95</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dyspareun$.mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">96</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin$ adj5 (dry$ or pain$)).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">97</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88 or 89 or 90 or 91 or 92 or 93 or 94 or 95 or 96</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">98</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 and 87 and 97</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">99</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 and 87 and 97</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23 and 32 and 87 and 97</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">101</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 and 32 and 97</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">102</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 and 32 and 97</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">103</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">98 or 99 or 100 or 101 or 102</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">104</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">remove duplicates from 103</td></tr><tr><td headers="hd_h_ch12.appb.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">105</td><td headers="hd_h_ch12.appb.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 104 to english language [general exclusions filter applied]</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab4"><div id="ch12.appb.tab4" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Pelvic Organ Prolapse] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic* near/3 organ* near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary near/3 bladder near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin* or urogenital* or genit* or uter* or viscer* or anterior* or posterior* or apical or pelvi* or vault* or urethr* or bladder*) near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos* or visceroptos*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Rectocele] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia* near/3 (pelvi* or vagin* or urogenital* or uter* or bladder* or urethr* or viscer*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethrocele* or urethrocoele* or enterocele* or enterocoele* or sigmoidocoele* or sigmoidocele* or proctocele* or proctocoele* or rectocele* or rectocoele* or cystocele* or cystocoele* or rectoenterocele* or rectoenterocoele* or cystourethrocele* or cystourethrocoele*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Urinary Incontinence, Stress] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine near/2 (loss or leak*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress* or mix* or effort*) near/5 incontinen*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10 or #11 or #12 or #13</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Urinary Incontinence] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urin* near/5 incontinen*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">UI:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15 or #16 or #17</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Surgical Mesh] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh* or non-mesh* or nonmesh*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Prostheses and Implants] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Biocompatible Materials] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog* or synthetic*) next implant*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19 or #20 or #21 or #22 or #23</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Minimally Invasive Surgical Procedures] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(minimally next invasive near/3 (surg* or resect* or approach* or technique* or treatment*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mesh* or tape* or sling*) near/3 (remov* or excis* or revis* or repair* or resect* or division*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">urethrolysis*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#29</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(transurethral* near/3 (excis* or approach* or technique* or cystoscop* or laser*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#30</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((laparoscopic* or robotic* or laser*) near/3 (excis* or approach* or technique*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#31</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin* near/3 excis*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#32</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((retropubic or suprapubic) near/3 dissect*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#33</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Natural Orifice Endoscopic Surgery] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((endoscop* or cystoscop* or hysteroscop*) near/3 (scissor* or grasper* or forcep*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#35</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((complete* or whole or wholly or partial*) near/3 excis*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#36</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrogens] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrogen Antagonists] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrogens, Conjugated (USP)] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#39</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estradiol] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#40</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estriol] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#41</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Estrone] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#42</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(oestrogen* or estrogen* or oestradiol* or estradiol* or oestriol* or estriol* or oestron* or estron* or Vagiferm* or estring* or e-string*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#43</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Pain Management] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#44</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Anesthetics, Local] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#45</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Analgesia] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#46</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Counseling] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#47</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Physical Therapy Modalities] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#48</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pain near/5 (manag* or therap* or treatment* or control*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#49</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(anaesthetic* or anesthetic* or analges*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#50</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((psycho-sex* or psychosex* or sex*) near/5 counsel*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#51</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">physiotherap*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#52</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Botulinum Toxins] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#53</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">botulinum*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#54</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(botul* near/2 tox*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#55</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(BTA or BTX or CNBTX or BoNT* or BoTx):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#56</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(botox or dysport or azzalure or oculinum or prosigne or purtox or vistabel or xeomin or bocouture or myobloc or rimabotulinum* or abobotuli* or onabotulinum* or Neuronox or Meditoxin):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#57</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Reconstructive Surgical Procedures] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#58</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin* near/5 reconstruct*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#59</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">vaginoplast*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#60</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Dilatation] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#61</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin* near/5 dilat*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#62</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 or #39 or #40 or #41 or #42 or #43 or #44 or #45 or #46 or #47 or #48 or #49 or #50 or #51 or 52 or #53 or #54 or #55 or #56 or #57 or #58 or #59 or #60 or #61</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#63</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Sexual Dysfunction, Physiological] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#64</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Sexual Dysfunctions, Psychological] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#65</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Dyspareunia] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#66</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sexual* near/5 (dysfunct* or problem* or symptom*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#67</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((sex* or intercourse) near/5 pain*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#68</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dyspareun*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#69</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin* near/5 (dry* or pain*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#70</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#63 or #64 or #65 or #66 or #67 or #68 or #69</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#71</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9 and #62 and #70</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#72</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 and #62 and #70</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#73</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18 and #24 and #62 and #70</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#74</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9 and #24 and 70</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#75</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 and #24 and #70</td></tr><tr><td headers="hd_h_ch12.appb.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#76</td><td headers="hd_h_ch12.appb.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#71 or #72 or #73 or #74 or #75</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab5"><div id="ch12.appb.tab5" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Pelvic Organ Prolapse/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp pelvic organ prolapse/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic$ adj3 organ$ adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary adj3 bladder adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin$ or urogenital$ or genit$ or uter$ or viscer$ or anterior$ or posterior$ or apical or pelvi$ or vault$ or urethr$ or bladder$) adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos$ or visceroptos$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rectocele/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">rectocele/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia$ adj3 (pelvi$ or vagin$ or urogenital$ or uter$ or bladder$ or urethr$ or viscer$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethroc?ele$ or enteroc?ele$ or sigmoidoc?ele$ or proctoc?ele$ or rectoc?ele$ or cystoc?ele$ or rectoenteroc?ele$ or cystourethroc?ele$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–10</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary Incontinence, Stress/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stress Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mixed Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine adj2 (loss or leak$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress$ or mix$ or effort$) adj5 incontinen$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/12–17</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary Incontinence/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">urine incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urin$ adj5 incontinen$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">UI.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/19–22</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Surgical Mesh/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp surgical mesh/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh$ or non-mesh$ or nonmesh$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*“Prostheses and Implants”/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*implant/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Biocompatible Materials/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*biomaterial/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog$ or synthetic$) adj implant$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/24–31</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Minimally Invasive Surgical Procedures/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp minimally invasive procedure/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(minimally adj invasive adj3 (surg$ or resect$ or approach$ or technique$ or treatment$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mesh$ or tape$ or sling$) adj3 (remov$ or excis$ or revis$ or repair$ or resect$ or division$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">urethrolysis$.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(transurethral$ adj3 (excis$ or approach$ or technique$ or cystoscop$ or laser$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((laparoscopic$ or robotic$ or laser$) adj3 (excis$ or approach$ or technique$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin$ adj3 excis$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((retropubic or suprapubic) adj3 dissect$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Natural Orifice Endoscopic Surgery/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">endoscopic surgery/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">scissors/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((endoscop$ or cystoscop$ or hysteroscop$) adj3 (scissor$ or grasper$ or forcep$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((complete$ or whole or wholly or partial$) adj3 excis$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/33–46</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 and 32 and 47</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 and 32 and 47</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23 and 32 and 47</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48 or 49 or 50</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">remove duplicates from 51</td></tr><tr><td headers="hd_h_ch12.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53</td><td headers="hd_h_ch12.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 52 to english language [general exclusions filter applied]</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab6"><div id="ch12.appb.tab6" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab6_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Pelvic Organ Prolapse] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic* near/3 organ* near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary near/3 bladder near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin* or urogenital* or genit* or uter* or viscer* or anterior* or posterior* or apical or pelvi* or vault* or urethr* or bladder*) near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos* or visceroptos*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Rectocele] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia* near/3 (pelvi* or vagin* or urogenital* or uter* or bladder* or urethr* or viscer*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethrocele* or urethrocoele* or enterocele* or enterocoele* or sigmoidocoele* or sigmoidocele* or proctocele* or proctocoele* or rectocele* or rectocoele* or cystocele* or cystocoele* or rectoenterocele* or rectoenterocoele* or cystourethrocele* or cystourethrocoele*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Urinary Incontinence, Stress] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine near/2 (loss or leak*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress* or mix* or effort*) near/5 incontinen*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10 or #11 or #12 or #13</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Urinary Incontinence] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urin* near/5 incontinen*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">UI:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15 or #16 or #17</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Surgical Mesh] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh* or non-mesh* or nonmesh*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Prostheses and Implants] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Biocompatible Materials] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog* or synthetic*) next implant*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19 or #20 or #21 or #22 or #23</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Minimally Invasive Surgical Procedures] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(minimally next invasive near/3 (surg* or resect* or approach* or technique* or treatment*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mesh* or tape* or sling*) near/3 (remov* or excis* or revis* or repair* or resect* or division*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">urethrolysis*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#29</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(transurethral* near/3 (excis* or approach* or technique* or cystoscop* or laser*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#30</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((laparoscopic* or robotic* or laser*) near/3 (excis* or approach* or technique*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#31</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(vagin* near/3 excis*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#32</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((retropubic or suprapubic) near/3 dissect*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#33</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Natural Orifice Endoscopic Surgery] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((endoscop* or cystoscop* or hysteroscop*) near/3 (scissor* or grasper* or forcep*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#35</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((complete* or whole or wholly or partial*) near/3 excis*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#36</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9 and #24 and #36</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 and #24 and #36</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#39</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18 and #24 and #36</td></tr><tr><td headers="hd_h_ch12.appb.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#40</td><td headers="hd_h_ch12.appb.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37 or #38 or #39</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab7"><div id="ch12.appb.tab7" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab7_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Pelvic Organ Prolapse/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp pelvic organ prolapse/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic$ adj3 organ$ adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary adj3 bladder adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin$ or urogenital$ or genit$ or uter$ or viscer$ or anterior$ or posterior$ or apical or pelvi$ or vault$ or urethr$ or bladder$) adj3 prolaps$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos$ or visceroptos$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rectocele/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">rectocele/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia$ adj3 (pelvi$ or vagin$ or urogenital$ or uter$ or bladder$ or urethr$ or viscer$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethroc?ele$ or enteroc?ele$ or sigmoidoc?ele$ or proctoc?ele$ or rectoc?ele$ or cystoc?ele$ or rectoenteroc?ele$ or cystourethroc?ele$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1–10</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Urinary Incontinence, Stress/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stress Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mixed Incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine adj2 (loss or leak$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress$ or mix$ or effort$) adj5 incontinen$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/12–17</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Surgical Mesh/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp surgical mesh/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh$ or non-mesh$ or nonmesh$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*“Prostheses and Implants”/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*implant/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Biocompatible Materials/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*biomaterial/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog$ or synthetic$) adj implant$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/19–26</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Biofeedback, Psychology/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">biofeedback/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">biofeedback$.tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 or 29 or 30</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Therapeutic Irrigation/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp lavage/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(irrigat$ or lavage$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 or 33 or 34</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electric Stimulation Therapy/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">sacral nerve stimulation/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sacral adj3 (stimul$ or neuromodul$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(SNS or SNM).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36 or 37 or 38 or 39</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Laxatives/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cathartics/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp laxative/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(laxative$ or aperiant$ or cathartic$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">prucalopride/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">linaclotide/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(prucaloprid$ or reolor$ or resotran$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(linaclotid$ or linzess$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41 or 42 or 43 or 44 or 45 or 46 or 47 or 48</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">proctopexy/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rectopex$ or proctopex$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50 or 51</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“stapled transanal rectal resection”/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((trans-anal$ or transanal$) adj3 resect$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(STARR adj5 (staple$ or trans-anal$ or transanal$ or resect$ or rectum$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53 or 54 or 55</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Enema/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Surgical Stomas/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">enema/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">stoma/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((antegrad$ or colon$) adj3 enema$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(ACE adj5 (antegrad$ or colon$ or enema$ or stoma$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(bowel adj3 washout$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57 or 58 or 59 or 60 or 61 or 62 or 63</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Life Style/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp lifestyle/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">lifestyle modification/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((lifestyle$ or life-style$) adj3 (advice$ or intervention$ or modif$ or change$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Weight Loss/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">weight reduction/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Diet Therapy/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp diet therapy/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Weight Reduction Programs/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">weight loss program/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(weight adj2 (los$ or reduc$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((caloric or hypocaloric) adj2 (restrict* or diet*)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dietary Fiber/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dietary fiber/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((fibre or fiber) adj3 (supplement$ or increase$ or intake$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((high-fibre high-fiber or high fibre or high fiber or fibre-rich or fiber-rich or fibre rich or fiber rich) adj diet$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">81</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(stool adj3 softener$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(bowel adj3 (re-train$ or retrain$ or train$ or re-educat$ or reeducat$ or educat$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">“Activities of Daily Living”/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical Exertion/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">85</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Physical Endurance/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">86</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">daily life activity/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">87</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp physical activity/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">endurance/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">89</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((heavy or repetitive) adj3 lift$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(activit$ adj3 (restrict$ or recommend$ or avoid$ or modif$ or change$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Health Behavior/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">92</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">health behavior/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">93</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Exercise/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">94</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Sports/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">95</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp exercise/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">96</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp sport/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">97</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((high adj impact) or (low adj impact)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">98</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(strong adj effort).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">99</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((exercis$ or activit$) adj3 (advice$ or intervention$ or modif$ or change$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85 or 86 or 87 or 88 or 89 or 90 or 91 or 92 or 93 or 94 or 95 or 96 or 97 or 98 or 99</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">101</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fecal Incontinence/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">102</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Constipation/ use ppez</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">103</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">feces incontinence/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">104</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">defecation disorder/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">105</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">constipation/ use emczd</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">106</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((fecal$ or feces$ or faeca$l or faeces$ or anal$ or anus$ or bowel$) adj3 incontinen$).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">107</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(obstruct$ adj3 (defecat$ or defaecat$)).mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">108</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">constipat$.mp.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">109</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">101 or 102 or 103 or 104 or 105 or 106 or 107 or 108</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">110</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((bowel$ or intestin$) adj3 (stricture$ or stenos$ or obstruct$ or fistul$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">111</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh$ adj3 (extru$ or expos$ or erosion$)).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">112</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(repair$ or resect$ or re-anastomos$ or anastomos$ or stoma$).tw.</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">113</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 or 18</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">114</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31 or 35 or 40 or 49 or 52 or 56 or 64 or 100</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">115</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">109 and 113 and 114</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">116</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 and 52</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">117</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">110 or 111</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">118</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">113 and 117</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">119</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">112 and 118</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">120</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11 and 52</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">121</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">115 or 116 or 119 or 120</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">122</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">remove duplicates from 121</td></tr><tr><td headers="hd_h_ch12.appb.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">123</td><td headers="hd_h_ch12.appb.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 122 to english language [general exclusions filter applied]</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appbtab8"><div id="ch12.appb.tab8" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appb.tab8_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">#</th><th id="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Searches</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Pelvic Organ Prolapse] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(pelvic* near/3 organ* near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urinary near/3 bladder near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((vagin* or urogenital* or genit* or uter* or viscer* or anterior* or posterior* or apical or pelvi* or vault* or urethr* or bladder*) near/3 prolaps*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(splanchnoptos* or visceroptos*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Rectocele] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hernia* near/3 (pelvi* or vagin* or urogenital* or uter* or bladder* or urethr* or viscer*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urethrocele* or urethrocoele* or enterocele* or enterocoele* or sigmoidocoele* or sigmoidocele* or proctocele* or proctocoele* or rectocele* or rectocoele* or cystocele* or cystocoele* or rectoenterocele* or rectoenterocoele* or cystourethrocele* or cystourethrocoele*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Urinary Incontinence, Stress] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((stress* or mix* or effort*) near/5 incontinen*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">SUI:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(urine near/2 (loss or leak*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Surgical Mesh] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">mesh*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Prostheses and Implants] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Biocompatible Materials] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((biolog* or synthetic*) next implant*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14 or #15 or #16 or #17 or #18</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Biofeedback, Psychology] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#21</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">biofeedback*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#22</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Therapeutic Irrigation] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#23</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(irrigat* or lavage*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#24</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Electric Stimulation Therapy] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#25</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(sacral near/3 (stimul* or neuromodul*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#26</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(SNS or SNM):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#27</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Laxatives] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#28</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Cathartics] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#29</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(laxative* or aperiant* or cathartic*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#30</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(prucaloprid* or reolor* or resotran* or linaclotid* or linzess*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#31</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((trans-anal* or transanal*) near/3 resect*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#32</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(STARR near/5 (staple* or trans-anal* or transanal* or resect* or rectum*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#33</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Enema] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#34</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Surgical Stomas] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#35</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((antegrad* or colon*) near/3 enema*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#36</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(ACE near/5 (antegrad* or colon* or enema* or stoma*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#37</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(bowel near/3 washout*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#39</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Life Style] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#40</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((lifestyle* or life-style*) near/3 (advice* or intervention* or modif* or change*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#41</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Weight Loss] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#42</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Diet Therapy] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#43</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Weight Reduction Programs] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#44</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(weight near/2 (los* or reduc*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#45</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((caloric or hypocaloric) near/2 (restrict* or diet*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#46</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Dietary Fiber] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#47</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((fibre or fiber) near/3 (supplement* or increase* or intake*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#48</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((high-fibre high-fiber or high fibre or high fiber or fibre-rich or fiber-rich or fibre rich or fiber rich) next diet*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#49</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(stool near/3 softener*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#50</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(bowel near/3 (re-train* or retrain* or train* or re-educat* or reeducat* or educat*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#51</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Activities of Daily Living] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#52</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Physical Exertion] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#53</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Physical Endurance] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#54</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((heavy or repetitive) near/3 lift*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#55</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(activit* near/3 (restrict* or recommend* or avoid* or modif* or change*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#56</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Health Behavior] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#57</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Exercise] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#58</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Sports] explode all trees</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#59</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((high next impact) or (low next impact)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#60</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(strong next effort):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#61</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((exercise* or activit*) near/3 (advice* or intervention* or modif* or change*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#62</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#39 or #40 or #41 or #42 or #43 or #44 or #45 or #46 or #47 or #48 or #49 or #50 or #51 or #52 or #53 or #54 or #55 or #56 or #57 or #58 or #59 or #60 or #61</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#63</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rectopex* or proctopex*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#64</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Fecal Incontinence] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#65</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Constipation] this term only</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#66</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((fecal* or feces* or faeca*l or faeces* or anal* or anus* or bowel*) near/3 incontinen*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#67</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(obstruct* near/3 (defecat* or defaecat*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#68</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">constipat*:ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#69</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#64 or #65 or #66 or #67 or #68</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#70</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((bowel* or intestin*) near/3 (stricture* or stenos* or obstruct* or fistul*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#71</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mesh* near/3 (extru* or expos* or erosion*)):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#72</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(repair* or resect* or re-anastomos* or anastomos* or stoma*):ti,ab,kw (Word variations have been searched)</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#73</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#38 or #62 or #63</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#74</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13 and #69 and #73</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#75</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#19 and #63</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#76</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 or #2 or #3 or #4 or #5 or #6 or #7 or #8</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#77</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#63 and #76</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#78</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#70 or #71</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#79</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13 and #72 and #78</td></tr><tr><td headers="hd_h_ch12.appb.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#80</td><td headers="hd_h_ch12.appb.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#74 or #75 or #77 or #79</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobch12appcfig1"><div id="ch12.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20PRISMA%20flow%20diagram%20for%20review%20of%20management%20of%20vaginal%20complications%20after%20mesh%20or%20mesh%20sling%20surgery.&p=BOOKS&id=577729_ch12appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577729/bin/ch12appcf1.jpg" alt="Figure 1. PRISMA flow diagram for review of management of vaginal complications after mesh or mesh sling surgery." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">PRISMA flow diagram for review of management of vaginal complications after mesh or mesh sling surgery</span></h3></div></article><article data-type="fig" id="figobch12appcfig2"><div id="ch12.appc.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20PRISMA%20flow%20diagram%20for%20review%20on%20management%20of%20sexual%20dysfunction%20and%2For%20pain%20complications%20after%20mesh%20or%20mesh%20sling%20surgery.&p=BOOKS&id=577729_ch12appcf2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577729/bin/ch12appcf2.jpg" alt="Figure 2. PRISMA flow diagram for review on management of sexual dysfunction and/or pain complications after mesh or mesh sling surgery." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">PRISMA flow diagram for review on management of sexual dysfunction and/or pain complications after mesh or mesh sling surgery</span></h3></div></article><article data-type="fig" id="figobch12appcfig3"><div id="ch12.appc.fig3" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20PRISMA%20flow%20diagram%20for%20review%20on%20management%20of%20urinary%20complications%20after%20mesh%20or%20mesh%20sling%20surgery.&p=BOOKS&id=577729_ch12appcf3.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577729/bin/ch12appcf3.jpg" alt="Figure 3. PRISMA flow diagram for review on management of urinary complications after mesh or mesh sling surgery." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">PRISMA flow diagram for review on management of urinary complications after mesh or mesh sling surgery</span></h3></div></article><article data-type="fig" id="figobch12appcfig4"><div id="ch12.appc.fig4" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%204.%20PRISMA%20flow%20diagram%20for%20review%20on%20management%20of%20bowel%20complications%20after%20mesh%20or%20mesh%20sling%20surgery.&p=BOOKS&id=577729_ch12appcf4.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577729/bin/ch12appcf4.jpg" alt="Figure 4. PRISMA flow diagram for review on management of bowel complications after mesh or mesh sling surgery." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">PRISMA flow diagram for review on management of bowel complications after mesh or mesh sling surgery</span></h3></div></article><article data-type="fig" id="figobch12appefig1"><div id="ch12.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%207.%20Recurrent%20SUI%20at%2012-mo%20follow%20up.&p=BOOKS&id=577729_ch12appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577729/bin/ch12appef1.jpg" alt="Figure 7. Recurrent SUI at 12-mo follow up." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 7</span><span class="title">Recurrent SUI at 12-mo follow up</span></h3></div></article><article data-type="table-wrap" id="figobch12appftab1"><div id="ch12.appf.tab1" class="table"><h3><span class="label">Table 29</span><span class="title">Evidence profile for partial mesh sling removal versus complete mesh sling removal in women with vaginal complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch12.appf.tab1_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch12.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch12.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab1_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch12.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab1_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch12.appf.tab1_1_1_1_1" id="hd_h_ch12.appf.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch12.appf.tab1_1_1_1_1" id="hd_h_ch12.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch12.appf.tab1_1_1_1_1" id="hd_h_ch12.appf.tab1_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch12.appf.tab1_1_1_1_1" id="hd_h_ch12.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch12.appf.tab1_1_1_1_1" id="hd_h_ch12.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch12.appf.tab1_1_1_1_1" id="hd_h_ch12.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch12.appf.tab1_1_1_1_1" id="hd_h_ch12.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch12.appf.tab1_1_1_1_2" id="hd_h_ch12.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Partial mesh removal</th><th headers="hd_h_ch12.appf.tab1_1_1_1_2" id="hd_h_ch12.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Complete mesh removal</th><th headers="hd_h_ch12.appf.tab1_1_1_1_3" id="hd_h_ch12.appf.tab1_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch12.appf.tab1_1_1_1_3" id="hd_h_ch12.appf.tab1_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_h_ch12.appf.tab1_1_1_2_3 hd_h_ch12.appf.tab1_1_1_2_4 hd_h_ch12.appf.tab1_1_1_2_5 hd_h_ch12.appf.tab1_1_1_2_6 hd_h_ch12.appf.tab1_1_1_2_7 hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_h_ch12.appf.tab1_1_1_2_9 hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_h_ch12.appf.tab1_1_1_2_11 hd_h_ch12.appf.tab1_1_1_1_4 hd_h_ch12.appf.tab1_1_1_1_5" id="hd_b_ch12.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Pain - At mean 5.9 weeks FU (follow-up mean 5.9 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_3 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_4 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_5 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_6 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_7 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>3/36</p>
|
|
<p>(8.3%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_9 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>12/58</p>
|
|
<p>(20.7%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.4 (0.12 to 1.33)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_11 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">124 fewer per 1000 (from 182 fewer to 68 more)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_4 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_5 hd_b_ch12.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_h_ch12.appf.tab1_1_1_2_3 hd_h_ch12.appf.tab1_1_1_2_4 hd_h_ch12.appf.tab1_1_1_2_5 hd_h_ch12.appf.tab1_1_1_2_6 hd_h_ch12.appf.tab1_1_1_2_7 hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_h_ch12.appf.tab1_1_1_2_9 hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_h_ch12.appf.tab1_1_1_2_11 hd_h_ch12.appf.tab1_1_1_1_4 hd_h_ch12.appf.tab1_1_1_1_5" id="hd_b_ch12.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Pain - At mean 28.6 weeks FU (follow-up mean 28.6 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_3 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_4 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_5 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_6 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_7 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>3/24</p>
|
|
<p>(12.5%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_9 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>11/32</p>
|
|
<p>(34.4%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.36 (0.11 to 1.16)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_11 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">220 fewer per 1000 (from 306 fewer to 55 more)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_4 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_5 hd_b_ch12.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_h_ch12.appf.tab1_1_1_2_3 hd_h_ch12.appf.tab1_1_1_2_4 hd_h_ch12.appf.tab1_1_1_2_5 hd_h_ch12.appf.tab1_1_1_2_6 hd_h_ch12.appf.tab1_1_1_2_7 hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_h_ch12.appf.tab1_1_1_2_9 hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_h_ch12.appf.tab1_1_1_2_11 hd_h_ch12.appf.tab1_1_1_1_4 hd_h_ch12.appf.tab1_1_1_1_5" id="hd_b_ch12.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">De novo urgency - At mean 5.9 weeks FU (follow-up mean 5.9 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_3 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_4 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_5 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_6 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_7 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>6/36</p>
|
|
<p>(16.7%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_9 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>12/58</p>
|
|
<p>(20.7%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.81 (0.33 to 1.96)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_11 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">39 fewer per 1000 (from 139 fewer to 199 more)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_4 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_5 hd_b_ch12.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_h_ch12.appf.tab1_1_1_2_3 hd_h_ch12.appf.tab1_1_1_2_4 hd_h_ch12.appf.tab1_1_1_2_5 hd_h_ch12.appf.tab1_1_1_2_6 hd_h_ch12.appf.tab1_1_1_2_7 hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_h_ch12.appf.tab1_1_1_2_9 hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_h_ch12.appf.tab1_1_1_2_11 hd_h_ch12.appf.tab1_1_1_1_4 hd_h_ch12.appf.tab1_1_1_1_5" id="hd_b_ch12.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">De novo urgency - At mean 28.6 weeks FU (follow-up mean 28.6 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_3 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_4 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_5 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_6 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_7 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>7/24</p>
|
|
<p>(29.2%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_9 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>12/32</p>
|
|
<p>(37.5%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.78 (0.36 to 1.68)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_11 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">83 fewer per 1000 (from 240 fewer to 255 more)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_4 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_5 hd_b_ch12.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_h_ch12.appf.tab1_1_1_2_3 hd_h_ch12.appf.tab1_1_1_2_4 hd_h_ch12.appf.tab1_1_1_2_5 hd_h_ch12.appf.tab1_1_1_2_6 hd_h_ch12.appf.tab1_1_1_2_7 hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_h_ch12.appf.tab1_1_1_2_9 hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_h_ch12.appf.tab1_1_1_2_11 hd_h_ch12.appf.tab1_1_1_1_4 hd_h_ch12.appf.tab1_1_1_1_5" id="hd_b_ch12.appf.tab1_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Recurrent SUI - At <=1 year (follow-up 1 years)</th></tr><tr><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_3 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_4 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_5 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_6 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_7 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>5/25</p>
|
|
<p>(20%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_9 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>24/40</p>
|
|
<p>(60%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.33 (0.15 to 0.71)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_11 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">402 fewer per 1000 (from 174 fewer to 510 fewer)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_4 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_5 hd_b_ch12.appf.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_h_ch12.appf.tab1_1_1_2_3 hd_h_ch12.appf.tab1_1_1_2_4 hd_h_ch12.appf.tab1_1_1_2_5 hd_h_ch12.appf.tab1_1_1_2_6 hd_h_ch12.appf.tab1_1_1_2_7 hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_h_ch12.appf.tab1_1_1_2_9 hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_h_ch12.appf.tab1_1_1_2_11 hd_h_ch12.appf.tab1_1_1_1_4 hd_h_ch12.appf.tab1_1_1_1_5" id="hd_b_ch12.appf.tab1_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Repeat surgery - At mean 28.6 weeks FU (follow-up mean 28.6 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_1 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_2 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_3 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_4 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_5 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_6 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch12.appf.tab1_1_1_1_1 hd_h_ch12.appf.tab1_1_1_2_7 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_8 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>2/24</p>
|
|
<p>(8.3%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_2 hd_h_ch12.appf.tab1_1_1_2_9 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>14/32</p>
|
|
<p>(43.8%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_10 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.19 (0.05 to 0.76)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_3 hd_h_ch12.appf.tab1_1_1_2_11 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">354 fewer per 1000 (from 105 fewer to 416 fewer)</td><td headers="hd_h_ch12.appf.tab1_1_1_1_4 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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|
</td><td headers="hd_h_ch12.appf.tab1_1_1_1_5 hd_b_ch12.appf.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch12.appf.tab1_1"><p class="no_margin">Overall serious risk of bias (serious risk of bias regarding confounding, selection of participants, classification of interventions, and measurement of outcomes).</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch12.appf.tab1_2"><p class="no_margin">95% CI crosses 2 default MIDs for dichotomous outcomes (0.8 and 1.25).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12appftab2"><div id="ch12.appf.tab2" class="table"><h3><span class="label">Table 30</span><span class="title">Clinical evidence profile for partial mesh sling removal versus complete mesh sling removal in women with sexual dysfunction and/or pain complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appf.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appf.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.appf.tab2_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch12.appf.tab2_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch12.appf.tab2_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch12.appf.tab2_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab2_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch12.appf.tab2_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab2_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1" id="hd_h_ch12.appf.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch12.appf.tab2_1_1_1_1" id="hd_h_ch12.appf.tab2_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch12.appf.tab2_1_1_1_1" id="hd_h_ch12.appf.tab2_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch12.appf.tab2_1_1_1_1" id="hd_h_ch12.appf.tab2_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch12.appf.tab2_1_1_1_1" id="hd_h_ch12.appf.tab2_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch12.appf.tab2_1_1_1_1" id="hd_h_ch12.appf.tab2_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch12.appf.tab2_1_1_1_1" id="hd_h_ch12.appf.tab2_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch12.appf.tab2_1_1_1_2" id="hd_h_ch12.appf.tab2_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Partial mesh removal</th><th headers="hd_h_ch12.appf.tab2_1_1_1_2" id="hd_h_ch12.appf.tab2_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Complete mesh removal</th><th headers="hd_h_ch12.appf.tab2_1_1_1_3" id="hd_h_ch12.appf.tab2_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch12.appf.tab2_1_1_1_3" id="hd_h_ch12.appf.tab2_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_h_ch12.appf.tab2_1_1_2_3 hd_h_ch12.appf.tab2_1_1_2_4 hd_h_ch12.appf.tab2_1_1_2_5 hd_h_ch12.appf.tab2_1_1_2_6 hd_h_ch12.appf.tab2_1_1_2_7 hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_h_ch12.appf.tab2_1_1_2_9 hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_h_ch12.appf.tab2_1_1_2_11 hd_h_ch12.appf.tab2_1_1_1_4 hd_h_ch12.appf.tab2_1_1_1_5" id="hd_b_ch12.appf.tab2_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Repeat SUI surgery - At mean 29 weeks FU (follow-up mean 29 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_3 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_4 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_5 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_6 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_7 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>29/78</p>
|
|
<p>(37.2%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_9 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>2/14</p>
|
|
<p>(14.3%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 2.6 (0.7 to 9.7)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_11 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">229 more per 1000 (from 43 fewer to 1000 more)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_4 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
|
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<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_5 hd_b_ch12.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_h_ch12.appf.tab2_1_1_2_3 hd_h_ch12.appf.tab2_1_1_2_4 hd_h_ch12.appf.tab2_1_1_2_5 hd_h_ch12.appf.tab2_1_1_2_6 hd_h_ch12.appf.tab2_1_1_2_7 hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_h_ch12.appf.tab2_1_1_2_9 hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_h_ch12.appf.tab2_1_1_2_11 hd_h_ch12.appf.tab2_1_1_1_4 hd_h_ch12.appf.tab2_1_1_1_5" id="hd_b_ch12.appf.tab2_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Postoperative Pain - At mean 6.4 weeks FU (follow-up mean 6.4 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_3 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_4 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_5 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_6 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_7 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>6/25</p>
|
|
<p>(24%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_9 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>35/126</p>
|
|
<p>(27.8%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.86 (0.41 to 1.83)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_11 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">39 fewer per 1000 (from 164 fewer to 231 more)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_4 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_5 hd_b_ch12.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_h_ch12.appf.tab2_1_1_2_3 hd_h_ch12.appf.tab2_1_1_2_4 hd_h_ch12.appf.tab2_1_1_2_5 hd_h_ch12.appf.tab2_1_1_2_6 hd_h_ch12.appf.tab2_1_1_2_7 hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_h_ch12.appf.tab2_1_1_2_9 hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_h_ch12.appf.tab2_1_1_2_11 hd_h_ch12.appf.tab2_1_1_1_4 hd_h_ch12.appf.tab2_1_1_1_5" id="hd_b_ch12.appf.tab2_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Postoperative Pain - At mean 29 weeks FU (follow-up mean 29 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_3 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_4 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_5 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_6 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_7 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>3/14</p>
|
|
<p>(21.4%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_9 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>30/78</p>
|
|
<p>(38.5%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.56 (0.2 to 1.58)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_11 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">169 fewer per 1000 (from 308 fewer to 223 more)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_4 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_5 hd_b_ch12.appf.tab2_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_h_ch12.appf.tab2_1_1_2_3 hd_h_ch12.appf.tab2_1_1_2_4 hd_h_ch12.appf.tab2_1_1_2_5 hd_h_ch12.appf.tab2_1_1_2_6 hd_h_ch12.appf.tab2_1_1_2_7 hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_h_ch12.appf.tab2_1_1_2_9 hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_h_ch12.appf.tab2_1_1_2_11 hd_h_ch12.appf.tab2_1_1_1_4 hd_h_ch12.appf.tab2_1_1_1_5" id="hd_b_ch12.appf.tab2_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Postoperative SUI - At mean 6.4 weeks FU (follow-up mean 6.4 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_3 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_4 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_5 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_6 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<sup>
|
|
3
|
|
</sup>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_7 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>8/25</p>
|
|
<p>(32%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_9 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>62/126</p>
|
|
<p>(49.2%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.65 (0.36 to 1.18)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_11 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">172 fewer per 1000 (from 315 fewer to 89 more)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_4 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_5 hd_b_ch12.appf.tab2_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_h_ch12.appf.tab2_1_1_2_3 hd_h_ch12.appf.tab2_1_1_2_4 hd_h_ch12.appf.tab2_1_1_2_5 hd_h_ch12.appf.tab2_1_1_2_6 hd_h_ch12.appf.tab2_1_1_2_7 hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_h_ch12.appf.tab2_1_1_2_9 hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_h_ch12.appf.tab2_1_1_2_11 hd_h_ch12.appf.tab2_1_1_1_4 hd_h_ch12.appf.tab2_1_1_1_5" id="hd_b_ch12.appf.tab2_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Postoperative SUI - At 29 weeks FU (follow-up mean 29 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_3 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_4 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_5 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_6 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_7 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>4/14</p>
|
|
<p>(28.6%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_9 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>51/78</p>
|
|
<p>(65.4%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.44 (0.19 to 1.02)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_11 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">366 fewer per 1000 (from 530 fewer to 13 more)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_4 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_5 hd_b_ch12.appf.tab2_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_h_ch12.appf.tab2_1_1_2_3 hd_h_ch12.appf.tab2_1_1_2_4 hd_h_ch12.appf.tab2_1_1_2_5 hd_h_ch12.appf.tab2_1_1_2_6 hd_h_ch12.appf.tab2_1_1_2_7 hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_h_ch12.appf.tab2_1_1_2_9 hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_h_ch12.appf.tab2_1_1_2_11 hd_h_ch12.appf.tab2_1_1_1_4 hd_h_ch12.appf.tab2_1_1_1_5" id="hd_b_ch12.appf.tab2_1_1_11_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Postoperative urge incontinence - At mean 6.4 weeks FU (follow-up mean 6.4 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_3 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_4 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_5 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_6 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_7 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>5/25</p>
|
|
<p>(20%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_9 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>49/126</p>
|
|
<p>(38.9%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.51 (0.23 to 1.16)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_11 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">191 fewer per 1000 (from 299 fewer to 62 more)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_4 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_5 hd_b_ch12.appf.tab2_1_1_11_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_h_ch12.appf.tab2_1_1_2_3 hd_h_ch12.appf.tab2_1_1_2_4 hd_h_ch12.appf.tab2_1_1_2_5 hd_h_ch12.appf.tab2_1_1_2_6 hd_h_ch12.appf.tab2_1_1_2_7 hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_h_ch12.appf.tab2_1_1_2_9 hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_h_ch12.appf.tab2_1_1_2_11 hd_h_ch12.appf.tab2_1_1_1_4 hd_h_ch12.appf.tab2_1_1_1_5" id="hd_b_ch12.appf.tab2_1_1_13_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Postoperative urge incontinence - At mean 29 weeks FU (follow-up mean 29 weeks)</th></tr><tr><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_1 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_2 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_3 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_4 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_5 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_6 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab2_1_1_1_1 hd_h_ch12.appf.tab2_1_1_2_7 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_8 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>4/14</p>
|
|
<p>(28.6%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_2 hd_h_ch12.appf.tab2_1_1_2_9 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>32/78</p>
|
|
<p>(41%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_10 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.7 (0.29 to 1.66)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_3 hd_h_ch12.appf.tab2_1_1_2_11 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">123 fewer per 1000 (from 291 fewer to 271 more)</td><td headers="hd_h_ch12.appf.tab2_1_1_1_4 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab2_1_1_1_5 hd_b_ch12.appf.tab2_1_1_13_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch12.appf.tab2_1"><p class="no_margin">Overall serious risk of bias (serious risk of bias regarding confounding, selection of participants, classification of interventions, and measurement of outcomes).</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch12.appf.tab2_2"><p class="no_margin">95% CI crosses 2 default MIDs for dichotomous outcomes (0.8 and 1.25).</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch12.appf.tab2_3"><p class="no_margin">95% CI crosses 1 default MID for dichotomous outcomes (0.8 or 1.25).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12appftab3"><div id="ch12.appf.tab3" class="table"><h3><span class="label">Table 31</span><span class="title">Clinical evidence profile for mesh removal versus mesh sling removal in women with sexual dysfunction and/or pain complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appf.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appf.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.appf.tab3_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch12.appf.tab3_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch12.appf.tab3_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch12.appf.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab3_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch12.appf.tab3_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab3_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch12.appf.tab3_1_1_1_1" id="hd_h_ch12.appf.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch12.appf.tab3_1_1_1_1" id="hd_h_ch12.appf.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch12.appf.tab3_1_1_1_1" id="hd_h_ch12.appf.tab3_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch12.appf.tab3_1_1_1_1" id="hd_h_ch12.appf.tab3_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch12.appf.tab3_1_1_1_1" id="hd_h_ch12.appf.tab3_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch12.appf.tab3_1_1_1_1" id="hd_h_ch12.appf.tab3_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch12.appf.tab3_1_1_1_1" id="hd_h_ch12.appf.tab3_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch12.appf.tab3_1_1_1_2" id="hd_h_ch12.appf.tab3_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mesh removal</th><th headers="hd_h_ch12.appf.tab3_1_1_1_2" id="hd_h_ch12.appf.tab3_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mesh sling removal</th><th headers="hd_h_ch12.appf.tab3_1_1_1_3" id="hd_h_ch12.appf.tab3_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch12.appf.tab3_1_1_1_3" id="hd_h_ch12.appf.tab3_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_1 hd_h_ch12.appf.tab3_1_1_2_2 hd_h_ch12.appf.tab3_1_1_2_3 hd_h_ch12.appf.tab3_1_1_2_4 hd_h_ch12.appf.tab3_1_1_2_5 hd_h_ch12.appf.tab3_1_1_2_6 hd_h_ch12.appf.tab3_1_1_2_7 hd_h_ch12.appf.tab3_1_1_1_2 hd_h_ch12.appf.tab3_1_1_2_8 hd_h_ch12.appf.tab3_1_1_2_9 hd_h_ch12.appf.tab3_1_1_1_3 hd_h_ch12.appf.tab3_1_1_2_10 hd_h_ch12.appf.tab3_1_1_2_11 hd_h_ch12.appf.tab3_1_1_1_4 hd_h_ch12.appf.tab3_1_1_1_5" id="hd_b_ch12.appf.tab3_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Resolution of pain complications (follow-up mean 3 years; assessed with: Visual analogue scale score of 0)</th></tr><tr><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_1 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_2 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_3 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_4 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_5 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_6 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_7 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab3_1_1_1_2 hd_h_ch12.appf.tab3_1_1_2_8 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>46/69</p>
|
|
<p>(66.7%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab3_1_1_1_2 hd_h_ch12.appf.tab3_1_1_2_9 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>44/54</p>
|
|
<p>(81.5%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab3_1_1_1_3 hd_h_ch12.appf.tab3_1_1_2_10 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.82 (0.66 to 1.01)</td><td headers="hd_h_ch12.appf.tab3_1_1_1_3 hd_h_ch12.appf.tab3_1_1_2_11 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">147 fewer per 1000 (from 277 fewer to 8 more)</td><td headers="hd_h_ch12.appf.tab3_1_1_1_4 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
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<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab3_1_1_1_5 hd_b_ch12.appf.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_1 hd_h_ch12.appf.tab3_1_1_2_2 hd_h_ch12.appf.tab3_1_1_2_3 hd_h_ch12.appf.tab3_1_1_2_4 hd_h_ch12.appf.tab3_1_1_2_5 hd_h_ch12.appf.tab3_1_1_2_6 hd_h_ch12.appf.tab3_1_1_2_7 hd_h_ch12.appf.tab3_1_1_1_2 hd_h_ch12.appf.tab3_1_1_2_8 hd_h_ch12.appf.tab3_1_1_2_9 hd_h_ch12.appf.tab3_1_1_1_3 hd_h_ch12.appf.tab3_1_1_2_10 hd_h_ch12.appf.tab3_1_1_2_11 hd_h_ch12.appf.tab3_1_1_1_4 hd_h_ch12.appf.tab3_1_1_1_5" id="hd_b_ch12.appf.tab3_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Persistent pelvic pain (follow-up mean 3 years; assessed with: No change on visual analogue scale)</th></tr><tr><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_1 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_2 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_3 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_4 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_5 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_6 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab3_1_1_1_1 hd_h_ch12.appf.tab3_1_1_2_7 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab3_1_1_1_2 hd_h_ch12.appf.tab3_1_1_2_8 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>11/69</p>
|
|
<p>(15.9%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab3_1_1_1_2 hd_h_ch12.appf.tab3_1_1_2_9 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>3/54</p>
|
|
<p>(5.6%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab3_1_1_1_3 hd_h_ch12.appf.tab3_1_1_2_10 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 2.87 (0.84 to 9.78)</td><td headers="hd_h_ch12.appf.tab3_1_1_1_3 hd_h_ch12.appf.tab3_1_1_2_11 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">104 more per 1000 (from 9 fewer to 488 more)</td><td headers="hd_h_ch12.appf.tab3_1_1_1_4 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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|
</td><td headers="hd_h_ch12.appf.tab3_1_1_1_5 hd_b_ch12.appf.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch12.appf.tab3_1"><p class="no_margin">Overall serious risk of bias (serious risk of bias regarding confounding, and measurement of outcomes).</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch12.appf.tab3_2"><p class="no_margin">95% CI crosses 1 default MID for dichotomous outcomes (0.8 or 1.25).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12appftab4"><div id="ch12.appf.tab4" class="table"><h3><span class="label">Table 32</span><span class="title">Clinical evidence profile for partial mesh removal versus complete mesh removal in women with mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appf.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appf.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.appf.tab4_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch12.appf.tab4_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch12.appf.tab4_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch12.appf.tab4_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab4_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch12.appf.tab4_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab4_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch12.appf.tab4_1_1_1_1" id="hd_h_ch12.appf.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch12.appf.tab4_1_1_1_1" id="hd_h_ch12.appf.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch12.appf.tab4_1_1_1_1" id="hd_h_ch12.appf.tab4_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch12.appf.tab4_1_1_1_1" id="hd_h_ch12.appf.tab4_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch12.appf.tab4_1_1_1_1" id="hd_h_ch12.appf.tab4_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch12.appf.tab4_1_1_1_1" id="hd_h_ch12.appf.tab4_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch12.appf.tab4_1_1_1_1" id="hd_h_ch12.appf.tab4_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch12.appf.tab4_1_1_1_2" id="hd_h_ch12.appf.tab4_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Partial mesh removal</th><th headers="hd_h_ch12.appf.tab4_1_1_1_2" id="hd_h_ch12.appf.tab4_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Complete mesh removal</th><th headers="hd_h_ch12.appf.tab4_1_1_1_3" id="hd_h_ch12.appf.tab4_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch12.appf.tab4_1_1_1_3" id="hd_h_ch12.appf.tab4_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_h_ch12.appf.tab4_1_1_2_3 hd_h_ch12.appf.tab4_1_1_2_4 hd_h_ch12.appf.tab4_1_1_2_5 hd_h_ch12.appf.tab4_1_1_2_6 hd_h_ch12.appf.tab4_1_1_2_7 hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_h_ch12.appf.tab4_1_1_2_9 hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_h_ch12.appf.tab4_1_1_2_11 hd_h_ch12.appf.tab4_1_1_1_4 hd_h_ch12.appf.tab4_1_1_1_5" id="hd_b_ch12.appf.tab4_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Improvement (follow-up 4–14 years)</th></tr><tr><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_3 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_4 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_5 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_6 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_7 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>7/17</p>
|
|
<p>(41.2%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_9 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>15/24</p>
|
|
<p>(62.5%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.66 (0.34 to 1.26)</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_11 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">212 fewer per 1000 (from 412 fewer to 162 more)</td><td headers="hd_h_ch12.appf.tab4_1_1_1_4 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch12.appf.tab4_1_1_1_5 hd_b_ch12.appf.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_h_ch12.appf.tab4_1_1_2_3 hd_h_ch12.appf.tab4_1_1_2_4 hd_h_ch12.appf.tab4_1_1_2_5 hd_h_ch12.appf.tab4_1_1_2_6 hd_h_ch12.appf.tab4_1_1_2_7 hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_h_ch12.appf.tab4_1_1_2_9 hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_h_ch12.appf.tab4_1_1_2_11 hd_h_ch12.appf.tab4_1_1_1_4 hd_h_ch12.appf.tab4_1_1_1_5" id="hd_b_ch12.appf.tab4_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">SF-12 - Mental component (follow-up 4–14 years; measured with: Medical Outcomes Study Short Form Survey Instrument; Better indicated by higher values)</th></tr><tr><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_3 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_4 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_5 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_6 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup><sup>,</sup><sup>4</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_7 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">17</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_9 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">24</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_11 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 8.92 lower (14.19 to 3.65 lower)</td><td headers="hd_h_ch12.appf.tab4_1_1_1_4 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch12.appf.tab4_1_1_1_5 hd_b_ch12.appf.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_h_ch12.appf.tab4_1_1_2_3 hd_h_ch12.appf.tab4_1_1_2_4 hd_h_ch12.appf.tab4_1_1_2_5 hd_h_ch12.appf.tab4_1_1_2_6 hd_h_ch12.appf.tab4_1_1_2_7 hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_h_ch12.appf.tab4_1_1_2_9 hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_h_ch12.appf.tab4_1_1_2_11 hd_h_ch12.appf.tab4_1_1_1_4 hd_h_ch12.appf.tab4_1_1_1_5" id="hd_b_ch12.appf.tab4_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">SF-12 - Physical component (follow-up 4–14 years; measured with: Medical Outcomes Study Short Form Survey Instrument; Better indicated by higher values)</th></tr><tr><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_3 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_4 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_5 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_6 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>4</sup><sup>,</sup><sup>5</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_7 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">17</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_9 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">24</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_11 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 0.56 higher (7.13 lower to 8.25 higher)</td><td headers="hd_h_ch12.appf.tab4_1_1_1_4 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
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<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab4_1_1_1_5 hd_b_ch12.appf.tab4_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_h_ch12.appf.tab4_1_1_2_3 hd_h_ch12.appf.tab4_1_1_2_4 hd_h_ch12.appf.tab4_1_1_2_5 hd_h_ch12.appf.tab4_1_1_2_6 hd_h_ch12.appf.tab4_1_1_2_7 hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_h_ch12.appf.tab4_1_1_2_9 hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_h_ch12.appf.tab4_1_1_2_11 hd_h_ch12.appf.tab4_1_1_1_4 hd_h_ch12.appf.tab4_1_1_1_5" id="hd_b_ch12.appf.tab4_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">PFDI-SF 20 (follow-up 4–14 years; measured with: Pelvic Floor Distress Inventory Short Form; Better indicated by lower values)</th></tr><tr><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_3 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_4 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_5 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_6 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>3</sup><sup>,</sup><sup>4</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_7 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">17</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_9 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">24</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_11 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MD 27.95 lower (60.67 lower to 4.77 higher)</td><td headers="hd_h_ch12.appf.tab4_1_1_1_4 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab4_1_1_1_5 hd_b_ch12.appf.tab4_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_h_ch12.appf.tab4_1_1_2_3 hd_h_ch12.appf.tab4_1_1_2_4 hd_h_ch12.appf.tab4_1_1_2_5 hd_h_ch12.appf.tab4_1_1_2_6 hd_h_ch12.appf.tab4_1_1_2_7 hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_h_ch12.appf.tab4_1_1_2_9 hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_h_ch12.appf.tab4_1_1_2_11 hd_h_ch12.appf.tab4_1_1_1_4 hd_h_ch12.appf.tab4_1_1_1_5" id="hd_b_ch12.appf.tab4_1_1_9_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Dyspareunia (follow-up 4–14 years)</th></tr><tr><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_1 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_2 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_3 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_4 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_5 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_6 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab4_1_1_1_1 hd_h_ch12.appf.tab4_1_1_2_7 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_8 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>11/14</p>
|
|
<p>(78.6%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab4_1_1_1_2 hd_h_ch12.appf.tab4_1_1_2_9 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>15/19</p>
|
|
<p>(78.9%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_10 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 1 (0.7 to 1.42)</td><td headers="hd_h_ch12.appf.tab4_1_1_1_3 hd_h_ch12.appf.tab4_1_1_2_11 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0 fewer per 1000 (from 237 fewer to 332 more)</td><td headers="hd_h_ch12.appf.tab4_1_1_1_4 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab4_1_1_1_5 hd_b_ch12.appf.tab4_1_1_9_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch12.appf.tab4_1"><p class="no_margin">Overall serious risk of bias (serious risk regarding confounding, selection of participants, classifications of interventions, and measurement of outcomes; moderate risk of bias regarding deviations from intended interventions).</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch12.appf.tab4_2"><p class="no_margin">95% CI crosses 2 default MIDs for dichotomous outcomes (0.8 and 1.25).</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="ch12.appf.tab4_3"><p class="no_margin">95% CI crosses 1 MID for this outcome.</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="ch12.appf.tab4_4"><p class="no_margin">MIDs, calculated as 0.5 times the SD of the complete removal group at baseline, for the following outcomes are: +/− 4.89 for SF-12 mental component; +/− 5.05 for SF-12 physical component; +/− 31.73 for PFDI-SF 20.</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="ch12.appf.tab4_5"><p class="no_margin">95% CI crosses 2 MIDs for this outcome.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12appftab5"><div id="ch12.appf.tab5" class="table"><h3><span class="label">Table 33</span><span class="title">Clinical evidence profile for mesh division versus mesh removal in women with mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appf.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appf.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.appf.tab5_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch12.appf.tab5_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch12.appf.tab5_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch12.appf.tab5_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab5_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch12.appf.tab5_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab5_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch12.appf.tab5_1_1_1_1" id="hd_h_ch12.appf.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch12.appf.tab5_1_1_1_1" id="hd_h_ch12.appf.tab5_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch12.appf.tab5_1_1_1_1" id="hd_h_ch12.appf.tab5_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch12.appf.tab5_1_1_1_1" id="hd_h_ch12.appf.tab5_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch12.appf.tab5_1_1_1_1" id="hd_h_ch12.appf.tab5_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch12.appf.tab5_1_1_1_1" id="hd_h_ch12.appf.tab5_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch12.appf.tab5_1_1_1_1" id="hd_h_ch12.appf.tab5_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch12.appf.tab5_1_1_1_2" id="hd_h_ch12.appf.tab5_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mesh division</th><th headers="hd_h_ch12.appf.tab5_1_1_1_2" id="hd_h_ch12.appf.tab5_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mesh removal</th><th headers="hd_h_ch12.appf.tab5_1_1_1_3" id="hd_h_ch12.appf.tab5_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch12.appf.tab5_1_1_1_3" id="hd_h_ch12.appf.tab5_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_1 hd_h_ch12.appf.tab5_1_1_2_2 hd_h_ch12.appf.tab5_1_1_2_3 hd_h_ch12.appf.tab5_1_1_2_4 hd_h_ch12.appf.tab5_1_1_2_5 hd_h_ch12.appf.tab5_1_1_2_6 hd_h_ch12.appf.tab5_1_1_2_7 hd_h_ch12.appf.tab5_1_1_1_2 hd_h_ch12.appf.tab5_1_1_2_8 hd_h_ch12.appf.tab5_1_1_2_9 hd_h_ch12.appf.tab5_1_1_1_3 hd_h_ch12.appf.tab5_1_1_2_10 hd_h_ch12.appf.tab5_1_1_2_11 hd_h_ch12.appf.tab5_1_1_1_4 hd_h_ch12.appf.tab5_1_1_1_5" id="hd_b_ch12.appf.tab5_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">SUI recurrence (follow-up 1.5–48 months)</th></tr><tr><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_1 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_2 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_3 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_4 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_5 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_6 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_7 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab5_1_1_1_2 hd_h_ch12.appf.tab5_1_1_2_8 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>6/45</p>
|
|
<p>(13.3%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab5_1_1_1_2 hd_h_ch12.appf.tab5_1_1_2_9 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>32/57</p>
|
|
<p>(56.1%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab5_1_1_1_3 hd_h_ch12.appf.tab5_1_1_2_10 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.24 (0.11 to 0.52)</td><td headers="hd_h_ch12.appf.tab5_1_1_1_3 hd_h_ch12.appf.tab5_1_1_2_11 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">427 fewer per 1000 (from 269 fewer to 500 fewer)</td><td headers="hd_h_ch12.appf.tab5_1_1_1_4 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab5_1_1_1_5 hd_b_ch12.appf.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr><tr><th headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_1 hd_h_ch12.appf.tab5_1_1_2_2 hd_h_ch12.appf.tab5_1_1_2_3 hd_h_ch12.appf.tab5_1_1_2_4 hd_h_ch12.appf.tab5_1_1_2_5 hd_h_ch12.appf.tab5_1_1_2_6 hd_h_ch12.appf.tab5_1_1_2_7 hd_h_ch12.appf.tab5_1_1_1_2 hd_h_ch12.appf.tab5_1_1_2_8 hd_h_ch12.appf.tab5_1_1_2_9 hd_h_ch12.appf.tab5_1_1_1_3 hd_h_ch12.appf.tab5_1_1_2_10 hd_h_ch12.appf.tab5_1_1_2_11 hd_h_ch12.appf.tab5_1_1_1_4 hd_h_ch12.appf.tab5_1_1_1_5" id="hd_b_ch12.appf.tab5_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Repeat SUI surgery (follow-up 1.5–48 months)</th></tr><tr><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_1 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_2 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_3 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_4 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_5 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_6 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch12.appf.tab5_1_1_1_1 hd_h_ch12.appf.tab5_1_1_2_7 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab5_1_1_1_2 hd_h_ch12.appf.tab5_1_1_2_8 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>2/45</p>
|
|
<p>(4.4%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab5_1_1_1_2 hd_h_ch12.appf.tab5_1_1_2_9 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>16/57</p>
|
|
<p>(28.1%)</p>
|
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</td><td headers="hd_h_ch12.appf.tab5_1_1_1_3 hd_h_ch12.appf.tab5_1_1_2_10 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.16 (0.04 to 0.65)</td><td headers="hd_h_ch12.appf.tab5_1_1_1_3 hd_h_ch12.appf.tab5_1_1_2_11 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">236 fewer per 1000 (from 98 fewer to 269 fewer)</td><td headers="hd_h_ch12.appf.tab5_1_1_1_4 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
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<p>⨁◯◯◯</p>
|
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<p>VERY LOW</p>
|
|
</td><td headers="hd_h_ch12.appf.tab5_1_1_1_5 hd_b_ch12.appf.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch12.appf.tab5_1"><p class="no_margin">Overall serious risk of bias (serious risk of bias regarding confounding, selection of participants, classification of interventions, and measurement of outcomes; moderate risk of bias regarding deviations from intended interventions).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12appftab6"><div id="ch12.appf.tab6" class="table"><h3><span class="label">Table 34</span><span class="title">Clinical evidence profile for transobturator mesh sling removal versus retropubic mesh sling removal in women with mesh complications</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appf.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appf.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch12.appf.tab6_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch12.appf.tab6_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch12.appf.tab6_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch12.appf.tab6_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab6_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch12.appf.tab6_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch12.appf.tab6_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch12.appf.tab6_1_1_1_1" id="hd_h_ch12.appf.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch12.appf.tab6_1_1_1_1" id="hd_h_ch12.appf.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch12.appf.tab6_1_1_1_1" id="hd_h_ch12.appf.tab6_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch12.appf.tab6_1_1_1_1" id="hd_h_ch12.appf.tab6_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch12.appf.tab6_1_1_1_1" id="hd_h_ch12.appf.tab6_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch12.appf.tab6_1_1_1_1" id="hd_h_ch12.appf.tab6_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch12.appf.tab6_1_1_1_1" id="hd_h_ch12.appf.tab6_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch12.appf.tab6_1_1_1_2" id="hd_h_ch12.appf.tab6_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">General - Transobturator</th><th headers="hd_h_ch12.appf.tab6_1_1_1_2" id="hd_h_ch12.appf.tab6_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Retropubic mesh removal</th><th headers="hd_h_ch12.appf.tab6_1_1_1_3" id="hd_h_ch12.appf.tab6_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch12.appf.tab6_1_1_1_3" id="hd_h_ch12.appf.tab6_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_1 hd_h_ch12.appf.tab6_1_1_2_2 hd_h_ch12.appf.tab6_1_1_2_3 hd_h_ch12.appf.tab6_1_1_2_4 hd_h_ch12.appf.tab6_1_1_2_5 hd_h_ch12.appf.tab6_1_1_2_6 hd_h_ch12.appf.tab6_1_1_2_7 hd_h_ch12.appf.tab6_1_1_1_2 hd_h_ch12.appf.tab6_1_1_2_8 hd_h_ch12.appf.tab6_1_1_2_9 hd_h_ch12.appf.tab6_1_1_1_3 hd_h_ch12.appf.tab6_1_1_2_10 hd_h_ch12.appf.tab6_1_1_2_11 hd_h_ch12.appf.tab6_1_1_1_4 hd_h_ch12.appf.tab6_1_1_1_5" id="hd_b_ch12.appf.tab6_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:middle;">Repeat SUI surgery (follow-up 3 months)</th></tr><tr><td headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_1 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_2 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_3 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_4 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_5 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_6 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>2</sup></td><td headers="hd_h_ch12.appf.tab6_1_1_1_1 hd_h_ch12.appf.tab6_1_1_2_7 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch12.appf.tab6_1_1_1_2 hd_h_ch12.appf.tab6_1_1_2_8 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>16/47</p>
|
|
<p>(34%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab6_1_1_1_2 hd_h_ch12.appf.tab6_1_1_2_9 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
|
|
<p>27/70</p>
|
|
<p>(38.6%)</p>
|
|
</td><td headers="hd_h_ch12.appf.tab6_1_1_1_3 hd_h_ch12.appf.tab6_1_1_2_10 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.88 (0.54 to 1.45)</td><td headers="hd_h_ch12.appf.tab6_1_1_1_3 hd_h_ch12.appf.tab6_1_1_2_11 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">46 fewer per 1000 (from 177 fewer to 174 more)</td><td headers="hd_h_ch12.appf.tab6_1_1_1_4 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW</p>
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</td><td headers="hd_h_ch12.appf.tab6_1_1_1_5 hd_b_ch12.appf.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch12.appf.tab6_1"><p class="no_margin">Overall serious of bias (serious risk of bias regarding confounding, classification of interventions, deviations from intended interventions, and measurement of outcomes).</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="ch12.appf.tab6_2"><p class="no_margin">95% CI crosses 2 default MIDs for dichotomous outcomes (0.8 and 1.25).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch12appktab1"><div id="ch12.appk.tab1" class="table"><h3><span class="label">Table 35</span><span class="title">Excluded clinical studies with reasons for exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appk.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appk.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appk.tab1_1_1_1_1" colspan="2" rowspan="1" style="text-align:left;vertical-align:middle;">Excluded studies - management for vaginal complications (including exposure, extrusion, erosion and infection) after mesh surgery?</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appk.tab1_1_1_1_1" id="hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th headers="hd_h_ch12.appk.tab1_1_1_1_1" id="hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bajory,Z., Fekete,Z., Kiraly,I., Szalay,I., Pajor,L., Consecutive vesicovaginal fistula for transobturator sling perforations and successful repairs with skin flap, Neurourology and Urodynamics, 30, 1530–1532, 2011</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only 3 patients, no relevant mesh complication</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Borie, F., Coste, T., Bigourdan, J. M., Guillon, F., Incidence and surgical treatment of synthetic mesh-related infectious complications after laparoscopic ventral rectopexy, Techniques in Coloproctology, 20, 759–765, 2016</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population type does not meet the inclusion criteria: Women treated for anal incontinence.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Crosby, E. C., Abernethy, M., Berger, M. B., DeLancey, J. O., Fenner, D. E., Morgan, D. M., Symptom resolution after operative management of complications from transvaginal mesh, Obstetrics & Gynecology Obstet Gynecol, 123, 134–9, 2014</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population type does not meet the inclusion criteria: Women referred for surgery due to pain.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Deval,B., Haab,F., Management of the complications of the synthetic slings, Current Opinion in Urology, 16, 240–243, 2006</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative review.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fabian, G., Kociszewski, J., Kuszka, A., Fabian, M., Grothey, S., Zwierzchowska, A., Majkusiak, W., Barcz, E., Vaginal excision of the sub-urethral sling: analysis of indications, safety and outcome, Archives of Medical Science, 11, 982–8, 2015</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">George, A., Mattingly, M., Woodman, P., Hale, D., Recurrence of prolapse after transvaginal mesh excision, Female Pelvic Medicine & Reconstructive SurgeryFemale pelvic med, 19, 202–5, 2013</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hogewoning, C. R., Elzevier, H. W., Pelger, R. C., Hogewoning, C. J., Results of collagen sling placement following the partial removal of a synthetic midurethral sling, International Journal of Gynaecology & ObstetricsInt J Gynaecol Obstet, 134, 286–9, 2016</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant intervention</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hokenstad, E. D., El-Nashar, S. A., Blandon, R. E., Occhino, J. A., Trabuco, E. C., Gebhart, J. B., Klingele, C. J., Health-related quality of life and outcomes after surgical treatment of complications from vaginally placed mesh, Female Pelvic Medicine & Reconstructive SurgeryFemale pelvic med, 21, 176–80, 2015</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Illiano, E., Sarti, E., Mancini, V., Carrieri, G., Cormio, L., Orcidi, D., Palleschi, G., Costantini, E., Wait and see: Is it a possible option in asymptomatic patients with mesh exposure?, Neurourology and urodynamics, 36, S15-S16, 2017</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ismail, S., Chartier-Kastler, E., Bitker, M. O., Roupret, M., Phe, V., Removal of synthetic tapes and meshes: Surgical indications and outcomes, European Urology, Supplements, 16 (3), e1727-e1728, 2017</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jeffery, S.T., Nieuwoudt, A., Beyond the complications: medium-term anatomical, sexual and functional outcomes following removal of trocar-guided transvaginal mesh. A retrospective cohort study, International Urogynecology Journal, 23, 1391–1396, 2012</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kowalik, C. R., Lakeman, M. M., Oryszczyn, J. E., Roovers, J. P., Reviewing Patients Following Mesh Repair; The Benefits, Gynecologic & Obstetric Investigation Gynecol Obstet Invest, 29, 29, 2016</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant outcomes</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Dillon, B., Lemack, G., Gomelsky, A., Zimmern, P., Transvaginal mesh kits-how “serious” are the complications and are they reversible?, Urology, 81, 43–8, 2013</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Marcus-Braun, N., von Theobald, P., Mesh removal following transvaginal mesh placement: a case series of 104 operations, International Urogynecology Journal, 21, 423–30, 2010</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Miklos, J. R., Chinthakanan, O., Moore, R. D., Karp, D. R., Nogueiras, G. M., Davila, G. W., Indications and Complications Associated with the Removal of 506 Pieces of Vaginal Mesh Used in Pelvic Floor Reconstruction: A Multicenter Study, Surgical Technology International, 29, 185–189, 2016</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Miklos, J. R., Chinthakanan, O., Moore, R. D., Mitchell, G. K., Favors, S., Karp, D. R., Northington, G. M., Nogueiras, G. M., Davila, G. W., The IUGA/ICS classification of synthetic mesh complications in female pelvic floor reconstructive surgery: a multicenter study, International Urogynecology Journal and Pelvic Floor Dysfunction, 27, 933–938, 2016</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant outcomes reported</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Milani, R., Frigerio, M., Palmieri, S., Manodoro, S., Transvaginal mesh removal with native-tissue repair for mesh shrinkage and recurrent uterovaginal prolapse following vaginal mesh-augmented surgery, International Journal of Gynecology and Obstetrics, 139, 105–106, 2017</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative report.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Milose, J. C., Sharp, K. M., He, C., Stoffel, J., Clemens, J. Q., Cameron, A. P., Success of autologous pubovaginal sling after failed synthetic mid urethral sling, Journal of Urology, 193, 916–20, 2015</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant intervention</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Misrai,V., Roupret,M., Xylinas,E., Cour,F., Vaessen,C., Haertig,A., Richard,F., Chartier-Kastler,E., Surgical resection for suburethral sling complications after treatment for stress urinary incontinence, Journal of Urology, 181, 2198–2202, 2009</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuman, M., Tension-free vaginal tape bladder penetration and long-lasting transvesical prolene material, Journal of Pelvic Medicine and Surgery, 10, 307–309, 2004</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes reported for women with bladder perforation by mesh</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rac, G., Greiman, A., Rabley, A., Tipton, T. J., Chiles, L. R., Freilich, D. A., Rames, R., Cox, L., Koski, M., Rovner, E. S., Analysis of Complications of Pelvic Mesh Excision Surgery Using the Clavien-Dindo Classification System, Journal of Urology, 19, 19, 2017</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ren,Y., Hong,L., Xu,E.X., Qi,X.Y., Mesh erosion after pelvic reconstructive surgeries, Saudi Medical Journal, 31, 180–184, 2010</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant outcomes</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Renezeder,K., Skala,C.E., Albrich,S., Koelbl,H., Naumann,G., Complications following the use of alloplastic materials in urogynecological surgery, European Journal of Obstetrics, Gynecology, and Reproductive Biology, 158, 354–357, 2011</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Skala, C. E., Renezeder, K., Albrich, S., Puhl, A., Laterza, R. M., Naumann, G., Koelbl, H., Mesh complications following prolapse surgery: Management and outcome, European Journal of Obstetrics Gynecology and Reproductive Biology, 159, 453–456, 2011</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Skoczylas, L. C., Shepherd, J. P., Smith, K. J., Lowder, J. L., Managing mesh exposure following vaginal prolapse repair: A decision analysis comparing conservative versus surgical treatment, International Urogynecology Journal and Pelvic Floor Dysfunction, 24, 119–125, 2013</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Modelling paper with narrative review.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stanford, E. J., Mattox, T. F., Pugh, C. J., Outcomes and Complications of Transvaginal and Abdominal Custom-shaped Light-weight Polypropylene Mesh Used in Repair of Pelvic Organ Prolapse, Journal of Minimally Invasive Gynecology, 18, 64–67, 2011</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant intervention</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stepanian, A. A., Miklos, J. R., Moore, R. D., Mattox, T. F., Risk of mesh extrusion and other mesh-related complications after laparoscopic sacral colpopexy with or without concurrent laparoscopic-assisted vaginal hysterectomy: experience of 402 patients, Journal of minimally invasive gynecology, 15, 188–96, 2008</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant intervention</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Vaish, S. S., Wolter, C. E., Management of Complications Related to Mesh Use Within the Female Pelvis, Current Bladder Dysfunction Reports, 1–6, 2010</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative paper.</td></tr><tr><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Warembourg, S., Labaki, M., de Tayrac, R., Costa, P., Fatton, B., Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center, International Urogynecology Journal, 1–13, 2017</td><td headers="hd_h_ch12.appk.tab1_1_1_1_1 hd_b_ch12.appk.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appktab2"><div id="ch12.appk.tab2" class="table"><h3><span class="label">Table 36</span><span class="title">Excluded studies with reasons for exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appk.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appk.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appk.tab2_1_1_1_1" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Excluded studies - What are the most effective management options for sexual dysfunction after mesh surgery? And What are the most effective management options for pain after mesh surgery?</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appk.tab2_1_1_1_1" id="hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th headers="hd_h_ch12.appk.tab2_1_1_1_1" id="hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abbott, J., The Use of Botulinum Toxin in the Pelvic Floor for Women with Chronic Pelvic Pain-A New Answer to Old Problems?, Journal of minimally invasive gynecology, 16, 130–135, 2009</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abbott, S., Unger, C. A., Evans, J. M., Jallad, K., Mishra, K., Karram, M. M., Iglesia, C. B., Rardin, C. R., Barber, M. D., Evaluation and management of complications from synthetic mesh after pelvic reconstructive surgery: a multicenter study, American Journal of Obstetrics & Gynecology, 210, 163.e1–8, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abdel-Fattah, M., Sivanesan, K., Ramsay, I., Pringle, S., Bjornsson, S., How common are tape erosions? A comparison of two versions of the transobturator tension-free vaginal tape procedure, BJU International, 98, 594–8, 2006</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=16)</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Abed, H., Rahn, D. D., Lowenstein, L., Balk, E. M., Clemons, J. L., Rogers, R. G., Systematic Review Group of the Society of Gynecologic, Surgeons, Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review, International Urogynecology Journal, 22, 789–98, 2011</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aggregation of data from studies not reported relative to pain nor sexual dysfunction complications.</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Achtari, C., Dwyer, P. L., Sexual function and pelvic floor disorders, Best Practice and Research: Clinical Obstetrics and Gynaecology, 19, 993–1008, 2005</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adel, E., Shapiro, R. E., Clemmer, M. J., Zaslau, S., Urethrolysis in the management of post-operative complications of mid-urethral slings, Female Pelvic Medicine and Reconstructive Surgery, 23 (5 Supplement 1), S127-S128, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Conference abstract; less than 75 women in sample</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Agnew, G., Dwyer, P. L., Rosamilia, A., Lim, Y., Edwards, G., Lee, J. K., Functional outcomes following surgical management of pain, exposure or extrusion following a suburethral tape insertion for urinary stress incontinence, International Urogynecology Journal, 25, 235–9, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=47); women, who had various complications, all had mesh revision</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Albertazzi,P., Sharma,S., Urogenital effects of selective estrogen receptor modulators: A systematic review, Climacteric, 8, 214–220, 2005</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ammembal, M. K., Radley, S. C., Complications of polypropylene mesh in prolapse surgery, Obstetrics, Gynaecology and Reproductive Medicine, 20, 359–363, 2010</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anonymous,, Management of Mesh and Graft Complications in Gynecologic Surgery, Female Pelvic Medicine & Reconstructive Surgery Female pelvic med, 23, 171–176, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">American College of Obstetricians and Gynaecologists and the American Urogynecologic Society opinion article</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Arsene, E., Giraudet, G., Lucot, J. P., Rubod, C., Cosson, M., Sacral colpopexy: long-term mesh complications requiring reoperation(s), International Urogynecology Journal and Pelvic Floor Dysfunction, 26, 353–358, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=27), majority of which had vaginal mesh erosion</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bachmann, G., The estradiol vaginal ring - A study of existing clinical data, Maturitas, 22, S21-S29, 1995</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Baessler, K., Maher, C. F., Mesh augmentation during pelvic-floor reconstructive surgery: Risks and benefits, Current Opinion in Obstetrics and Gynecology, 18, 560–566, 2006</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Baessler, K., Wildt, B., Tunn, R., Prevalence, Management, and Prevention of Mesh Complications After Use in the Posterior Vaginal Compartment, Seminars in Colon and Rectal Surgery, 20, 139–146, 2009</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant studies identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Baessler,K., Hewson,A.D., Tunn,R., Schuessler,B., Maher,C.F., Severe mesh complications following intravaginal slingplasty, Obstetrics and Gynecology, 106, 713–716, 2005</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=19), all of whom had various complications</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ballagh,S.A., Vaginal hormone therapy for urogenital and menopausal symptoms, Seminars in Reproductive Medicine, 23, 126–140, 2005</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Barber, M. D., Surgical techniques for removing problematic mesh, Clinical Obstetrics & Gynecology Clin Obstet Gynecol, 56, 289–302, 2013</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Barski, D., Deng, D. Y., Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature, BioMed Research International, 2015, 831285, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant studies identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Basu, M., Gorti, M., Onifade, R., Franco, A., Fynes, M., Doumouchtsis, S. K., Continence outcomes following partial excision of vaginal mesh exposure after mid-urethral tape insertion, European Journal of Obstetrics, Gynecology, & Reproductive Biology, 167, 114–7, 2013</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=41); women, who had various complications, all had vaginal mesh exposure</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bekarma, H., Granitsiotis, P., The one-year experience of tape and mesh removal at a urological tertiary referral centre, Journal of Clinical Urology, 10, 336–339, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=25); women, who had various complications, all had mesh removal</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bertolasi,L., Frasson,E., Graziottin,A., Botulinum toxin treatment of pelvic floor disorders and genital pain in women, Current Women’s Health Reviews, 4, 180–187, 2008</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Article not available</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bhide, A. A., Puccini, F., Khullar, V., Elneil, S., Alessandro Digesu, G., Botulinum neurotoxin type A injection of the pelvic floor muscle in pain due to spasticity: A review of the current literature, International Urogynecology Journal, 24, 1429–1434, 2013</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Blaivas, J. G., Sandhu, J., Urethral reconstruction after erosion of slings in women, Current Opinion in Urology, 14, 335–8, 2004</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bouman, M. B., van Zeijl, M. C. T., Buncamper, M. E., Meijerink, W. J. H. J., van Bodegraven, A. A., Mullender, M. G., Intestinal vaginoplasty revisited: A review of surgical techniques, complications, and sexual function, Journal of sexual medicine, 11, 1835–1847, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Brown, E. T., Cohn, J., Kaufman, M., Dmochowski, R., Reynolds, W. S., Evaluation and Management of Mid-Urethral Sling Complications, Current Bladder Dysfunction Reports, 11, 160–168, 2016</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Included Danford 2015 and Hou 2014, no other relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cardenas-Trowers, O. O., Malekzadeh, P., Nix, D. E., Hatch, K. D., Vaginal Mesh Removal Outcomes: Eight Years of Experience at an Academic Hospital, Female Pelvic Medicine & Reconstructive Surgery Female pelvic med, 20, 20, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All women had mesh removal (n=83) and variety of complications; Data not reported according to type of complication</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chen, J., Sweet, G., Shindel, A., Urinary disorders and female sexual function, Current Urology Reports, 14, 298–308, 2013</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chermansky,C.J., Winters,J.C., Complications of vaginal mesh surgery, Current Opinion in Urology, 22, 287–291, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clemens, J. Q., Delancey, J. O., Faerber, G. J., Westney, O. L., McGuire, E. J., Urinary tract erosions after synthetic pubovaginal slings: Diagnosis and management strategy, Urology, 56, 589–594, 2000</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=14); women, who had variety of complications, all had mesh erosion</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cohen, S. A., Goldman, H. B., Mesh Perforation into a Viscus in the Setting of Pelvic Floor Surgery-Presentation and Management, Current Urology Reports, 17 (9) (no pagination), 2016</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cornu, J. N., Peyrat, L., Haab, F., Update in management of vaginal mesh erosion, Current Urology Reports, 14, 471–5, 2013</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Costantini, E., Zucchi, A., Lazzeri, M., Del Zingaro, M., Vianello, A., Porena, M., Managing mesh erosion after abdominal pelvic organ prolapse repair: ten years’ experience in a single center, Urologia Internationalis, 86, 419–23, 2011</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=12); women had variety of complications</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Crosby, E. C., Abernethy, M., Berger, M. B., DeLancey, J. O., Fenner, D. E., Morgan, D. M., Symptom resolution after operative management of complications from transvaginal mesh, Obstetrics & Gynecology Obstet Gynecol, 123, 134–9, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Deffieux, X., Tayrac, R., Huel, C., Bottero, J., Gervaise, A., Bonnet, K., Frydman, R., Fernandez, H., Vaginal mesh erosion after transvaginal repair of cystocele using Gynemesh or Gynemesh-Soft in 138 women: A comparative study, International Urogynecology Journal, 18, 73–79, 2007</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=27); all women had vaginal mesh erosion, with only 12 sexually active women across both mesh groups before treatment</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Deval,B., Haab,F., Management of the complications of the synthetic slings, Current Opinion in Urology, 16, 240–243, 2006</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Doumouchtsis, S. K., Boama, V., Gorti, M., Tosson, S., Fynes, M. M., Prospective evaluation of combined local bupivacaine and steroid injections for the management of chronic vaginal and perineal pain, Archives of Gynecology & Obstetrics Arch Gynecol Obstet, 284, 681–5, 2011</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in mixed sample of women feeling pain after either childbirth or gynaecological surgery; only 10 women had prior such surgery</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Duckett, J., Morley, R., Monga, A., Hillard, T., Robinson, D., Mesh removal after vaginal surgery: what happens in the UK?, International Urogynecology Journal, 28, 989–992, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Survey of UK surgeons/No relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Duckett,J.R., Jain,S., Groin pain after a tension-free vaginal tape or similar suburethral sling: management strategies, BJU International, 95, 95–97, 2005</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=5); all had groin pain</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eder,S.E., Ospemifene: a novel selective estrogen receptor modulator for treatment of dyspareunia, Women’s health, 10, 499–503, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Overview of research on ospemifene/no relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Espuna, M., Puig, M., Carmona, F., De novo dyspareunia after pelvic organ prolapse surgery, Gynecological Surgery, 7, 217–225, 2010</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fabian, G., Kociszewski, J., Kuszka, A., Fabian, M., Grothey, S., Zwierzchowska, A., Majkusiak, W., Barcz, E., Vaginal excision of the sub-urethral sling: analysis of indications, safety and outcome, Archives of Medical Science, 11, 982–8, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All women had sling removal (n=100); only 40 had some form of pain (including dyspareunia, pain on walking etc.)</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Falagas, M. E., Velakoulis, S., Iavazzo, C., Athanasiou, S., Mesh-related infections after pelvic organ prolapse repair surgery, European Journal of Obstetrics, Gynecology, & Reproductive Biology, 134, 147–56, 2007</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Feiner, B., Maher, C., Vaginal mesh contraction: definition, clinical presentation, and management, Obstetrics & Gynecology Obstet Gynecol, 115, 325–30, 2010</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample; all 17 women had vaginal pain, 14 of which had dyspareunia</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Forde, J. C., Davis, N. F., Creagh, T. A., Evaluation of Presenting Symptoms and Long-Term Outcomes of Patients Requiring Excision of a Transobturator Tape (TOT), Irish Medical Journal, 108, 270–2, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=16); all had mesh excision, 9 of which had dyspareunia</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gilchrist,A.S., Rovner,E.S., Managing complications of slings, Current Opinion in Urology, 21, 291–296, 2011</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Giri,S.K., Sil,D., Narasimhulu,G., Flood,H.D., Skehan,M., Drumm,J., Management of Vaginal Extrusion After Tension-Free Vaginal Tape Procedure for Urodynamic Stress Incontinence, Urology, 69, 1077–1080, 2007</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample; only 5 had vaginal mesh extrusion and variety of complications.</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hokenstad, E. D., El-Nashar, S. A., Blandon, R. E., Occhino, J. A., Trabuco, E. C., Gebhart, J. B., Klingele, C. J., Health-related quality of life and outcomes after surgical treatment of complications from vaginally placed mesh, Female Pelvic Medicine & Reconstructive SurgeryFemale pelvic med, 21, 176–80, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=41); all had mesh repair, only 29 of them were sexually active</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Javadian, P., O’Leary, D., Vaginally Placed Meshes: A Review of Their Complications, Risk Factors, and Management, Current Obstetrics and Gynecology Reports, 4, 96–101, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not systematic review/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jeffery, S.T., Nieuwoudt, A., Beyond the complications: medium-term anatomical, sexual and functional outcomes following removal of trocar-guided transvaginal mesh. A retrospective cohort study, International Urogynecology Journal, 23, 1391–1396, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=21); all had mesh removal</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jha, S, Ammenbal, M, Metwally, M, Impact of incontinence surgery on sexual function: a systematic review and meta-analysis (Provisional abstract), Journal of Sexual Medicine, 9, 34–43, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Karram, M., Brown, E. T., Avoiding and Managing Complications of Synthetic Midurethral Slings, Current Bladder Dysfunction Reports, 10, 64–70, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kobashi,K.C., Dmochowski,R., Mee,S.L., Mostwin,J., Nitti,V.W., Zimmern,P.E., Leach,G.E., Erosion of woven polyester pubovaginal sling, Journal of Urology, 162, 2070–2072, 1999</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=34); all had synthetic sling removal</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kuhn,A., Burkhard,F., Eggemann,C., Mueller,M.D., Sexual function after suburethral sling removal for dyspareunia, Surgical Endoscopy, 23, 765–768, 2009</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=18); all had de novo dyspareunia and sling removal</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kuhn,A., Eggeman,C., Burkhard,F., Mueller,M.D., Correction of erosion after suburethral sling insertion for stress incontinence: results and related sexual function, European Urology, 56, 371–376, 2009</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=21); all had mesh erosion and mesh removal</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Bacsu, C., Dillon, B., Zimmern, P. E., Complications Following the Insertion of Two Synthetic Mid-urethral Slings and Subsequent Removal, LUTS: Lower Urinary Tract Symptoms., 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=21); variety of complications, all had mesh removal</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Bacsu, C., Zimmern, P. E., Meshology: A fast-growing field involving mesh and/or tape removal procedures and their outcomes, Expert Review of Medical Devices, 12, 201–216, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Chang, J., Zimmern, P. E., Iatrogenic Pelvic Pain: Surgical and Mesh Complications, Physical Medicine and Rehabilitation Clinics of North America, 28, 603–619, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No other relevant articles identified; Danford et al. 2015, n=233 reports on improvement in women with pain complications after mesh surgery who underwent revision but does not use validated scale</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Dillon, B., Lemack, G., Gomelsky, A., Zimmern, P., Transvaginal mesh kits-how “serious” are the complications and are they reversible?, Urology, 81, 43–8, 2013</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample with pain or sexual dysfunction (n=58); all had mesh removal and most had multiple complications (dyspareunia, n=42; pelvic pain, n=26)</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Zimmern, P. E., Management of complications of mesh surgery, Current Opinion in Urology, 25, 284–291, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lim,Y.N., Muller,R., Corstiaans,A., Hitchins,S., Barry,C., Rane,A., A long-term review of posterior colporrhaphy with Vypro 2 mesh, International Urogynecology Journal, 18, 1053–1057, 2007</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 75 women in sample (n=53); all women had posterior colporrhaphy. No relevant outcomes reported</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lo, T. S., Tan, Y. L., Cortes, E. F., Wu, P. Y., Pue, L. B., Al-Kharabsheh, A., Clinical outcomes of mesh exposure/extrusion: presentation, timing and management, Australian & New Zealand Journal of Obstetrics & GynaecologyAust N Z J Obstet Gynaecol, 55, 284–90, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=40); all had mesh exposure/extrusion and variety of complications</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MacDonald, S., Terlecki, R., Costantini, E., Badlani, G., Complications of Transvaginal Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence: Tips for Prevention, Recognition, and Management, European Urology Focus, 2, 260–267, 2016</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Article not available</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Marks,B.K., Goldman,H.B., Controversies in the management of mesh-based complications: a urology perspective, Urologic Clinics of North America, 39, 419–428, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Miklos, J. R., Chinthakanan, O., Moore, R. D., Karp, D. R., Nogueiras, G. M., Davila, G. W., Indications and Complications Associated with the Removal of 506 Pieces of Vaginal Mesh Used in Pelvic Floor Reconstruction: A Multicenter Study, Surgical Technology International, 29, 185–189, 2016</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All women had mesh removal (n=445). No relevant outcomes reported.</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mock, S., Reynolds, W. S., Dmochowski, R. R., Trans-vaginal mesh revision: A comprehensive review on etiologies and management strategies with emphasis on postoperative pain outcomes, LUTS: Lower Urinary Tract Symptoms, 6, 69–75, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moore, R. D., Miklos, J. R., Chinthakanan, O., Vaginal reconstruction/rejuvenation: is there data to support improved sexual function? An update and review of the literature, Surgical Technology International Surg Technol Int, 25, 179–90, 2014</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Morrissey, D., El-Khawand, D., Ginzburg, N., Wehbe, S., O’Hare, P., 3rd, Whitmore, K., Botulinum Toxin A Injections Into Pelvic Floor Muscles Under Electromyographic Guidance for Women With Refractory High-Tone Pelvic Floor Dysfunction: A 6-Month Prospective Pilot Study, Female pelvic medicine & reconstructive surgery, 21, 277–82, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=28); no further details provided of type of dysfunction</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Muffly, T. M., Barber, M. D., Insertion and removal of vaginal mesh for pelvic organ prolapse, Clinical Obstetrics and Gynecology, 53, 99–114, 2010</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nappi,R.E., Davis,S.R., The use of hormone therapy for the maintenance of urogynecological and sexual health post WHI, Climacteric, 15, 267–274, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Parden, A. M., Tang, Y., Szychowski, J., Richter, H. E., Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision, Journal of Minimally Invasive Gynecology, 23, 979–985, 2016</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 75 women in sample (n=69); all had mesh surgery with 35% (n=24) having dyspareunia and 42% (n=29) having some other form of pain. Reporting of data for women with dyspareunia or pain inadequate/unclear</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pickett, S. D., Barenberg, B., Quiroz, L. H., Shobeiri, S. A., O’Leary, D. E., The significant morbidity of removing pelvic mesh from multiple vaginal compartments, Obstetrics and gynecology, 125, 1418–1422, 2015</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All women (n=374) had mesh removal for variety of complications (57% had dyspareunia [n=223], 63% [n=247] had other form of pain). No relevant outcomes specific for management sexual dysfunction nor pain reported</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rac, G., Greiman, A., Rabley, A., Tipton, T. J., Chiles, L. R., Freilich, D. A., Rames, R., Cox, L., Koski, M., Rovner, E. S., Analysis of Complications of Pelvic Mesh Excision Surgery Using the Clavien-Dindo Classification System, Journal of Urology, 19, 19, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All women had mesh removal (n=277) but no details provided of indication for this surgery</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ramart, P., Ackerman, A. L., Cohen, S. A., Kim, J. H., Raz, S., The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications, Urology, 106, 203–209, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">All women in both mesh groups (retropubic vs. transobturator) had mesh removal; in whole sample, 46% (n=54) had dyspareunia, 6% (n=7) had hispareunia, and between 5–35% had some form of other pain. Outcomes not reported relative to specific complications of sexual dysfunction nor pain</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reisenauer, C., Viereck, V., Mesh-related complications in urogynecology - A multidisciplinary challenge, Acta Obstetricia et Gynecologica Scandinavica, 91, 869–872, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample; Case report of 11 women</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ridgeway, B., Walters, M. D., Paraiso, M. F., Barber, M. D., McAchran, S. E., Goldman, H. B., Jelovsek, J. E., Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits, American Journal of Obstetrics & Gynecology 199, 703.e1–7, 2008</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=19); all women had mesh excision with only 32% (n=6) having dyspareunia and 32% (n=6) having some other form of pain</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rigaud, J., Pothin, P., Labat, J. J., Riant, T., Guerineau, M., Normand, L. L., Glemain, P., Robert, R., Bouchot, O., Functional results after tape removal for chronic pelvic pain following tension-free vaginal tape or transobturator tape, Journal of urology, 184, 610–615, 2010</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=32); all had chronic or perineal pain and had sling removal</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sinha,D., Thomson,A.J., Botulinum toxin for pelvic pain in women, Women’s Health, 4, 173–181, 2008</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Skala, C. E., Renezeder, K., Albrich, S., Puhl, A., Laterza, R. M., Naumann, G., Koelbl, H., Mesh complications following prolapse surgery: Management and outcome, European Journal of Obstetrics Gynecology and Reproductive Biology, 159, 453–456, 2011</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample with pain or sexual dysfunction (n=54); all had mesh revision with only 17% (n=9) having dyspareunia and 50% (n=27) having other form of pain</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Skala,C., Renezeder,K., Albrich,S., Puhl,A., Laterza,R.M., Naumann,G., Koelbl,H., The IUGA/ICS classification of complications of prosthesis and graft insertion: a comparative experience in incontinence and prolapse surgery, International Urogynecology Journal, 22, 1429–1435, 2011</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample with pain or sexual dysfunction: In prolapse group (n=54), 17% (n=9) had dyspareunia and 50% (n=27) had other form of pain. In incontinence surgery group, <1% (n=9) had dyspareunia and 26% (n=32) had some other form of pain. No relevant outcomes reported.</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Warembourg, S., Labaki, M., de Tayrac, R., Costa, P., Fatton, B., Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center, International Urogynecology Journal, 1–13, 2017</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 75 women in sample with pain or sexual dysfunction (n=67); variety of complications with 33% having pain and 23% dyspareunia</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Willy Davila, G., Jijon, A., Managing vaginal mesh exposure/erosions, Current Opinion in Obstetrics and Gynecology, 24, 343–348, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wiltz, A. L., Reynolds, W. S., Jayram, G., Fedunok, P. A., Bales, G. T., Management of vaginal synthetic graft extrusion following surgery for stress urinary incontinence and prolapse, Current Urology, 3, 82–86, 2009</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample (n=27); all had mesh removal with only 14 % (n=4) having pain or dyspareunia</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wohlrab,K.J., Erekson,E.A., Myers,D.L., Postoperative erosions of the Mersilene suburethral sling mesh for antiincontinence surgery, International Urogynecology Journal, 20, 417–420, 2009</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than 50 women in sample with pain or sexual dysfunction (n=62); all had revision/excision of Mersilene sling with only 13% (n=8) having pain or dyspareunia</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wolff, G. F., Winters, J. C., Krlin, R. M., Mesh Excision: Is Total Mesh Excision Necessary?, Current Urology Reports, 17, 34, 2016</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zambon, J. P., Badlani, G. H., Vaginal Mesh Exposure Presentation, Evaluation, and Management, Current Urology Reports, 17 (9) (no pagination), 2016</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr><tr><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zoorob, D., Karram, M., Management of Mesh Complications and Vaginal Constriction. A Urogynecology Perspective, Urologic Clinics of North America, 39, 413–418, 2012</td><td headers="hd_h_ch12.appk.tab2_1_1_1_1 hd_b_ch12.appk.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-systematic review of surgical techniques/no additional relevant articles identified</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appktab3"><div id="ch12.appk.tab3" class="table"><h3><span class="label">Table 37</span><span class="title">Excluded clinical studies with reasons for exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appk.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appk.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appk.tab3_1_1_1_1" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Excluded studies - What are the most effective management options for urinary complications after mesh surgery?</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appk.tab3_1_1_1_1" id="hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th headers="hd_h_ch12.appk.tab3_1_1_1_1" id="hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Barski, D., Deng, D. Y., Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature, BioMed Research International, 2015, 831285, 2015</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative review</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cardenas-Trowers, O. O., Malekzadeh, P., Nix, D. E., Hatch, K. D., Vaginal Mesh Removal Outcomes: Eight Years of Experience at an Academic Hospital, Female Pelvic Medicine & Reconstructive Surgery Female pelvic med, 20, 20, 2017</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Revision surgery due to pain</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Coskun, B., Lavelle, R. S., Alhalabi, F., Lemack, G., Zimmern, P. E., Urodynamics for incontinence after midurethral sling removal, Neurourology & Urodynamics, 35, 939–943, 2016</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">UDS not mesh complication management</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Crosby, E. C., Abernethy, M., Berger, M. B., DeLancey, J. O., Fenner, D. E., Morgan, D. M., Symptom resolution after operative management of complications from transvaginal mesh, Obstetrics & Gynecology Obstet Gynecol, 123, 134–9, 2014</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Referred due to pain only outcome presented relates to improvement in pain</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dasgupta,J., Goddard,J.C., Mayne,C.J., Tincello,D.G., The management of voiding dysfunction following mid urethral tape insertion, British Journal of Medical and Surgical Urology, 4, 31–35, 2011</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Examining TVT surgery not management of complications</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Duckett,J.R.A., Jain,S., Groin pain after a tension-free vaginal tape or similar suburethral sling: Management strategies, BJU International, 95, 95–97, 2005</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">less than 20 participants</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dunn Jr, J. S., Bent, A. E., Ellerkman, R., Nihira, M. A., Melick, C. F., Voiding dysfunction after surgery for stress incontinence: Literature review and survey results, International Urogynecology Journal, 15, 25–31, 2004</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review paper and survey of surgeons.</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fabian, G., Kociszewski, J., Kuszka, A., Fabian, M., Grothey, S., Zwierzchowska, A., Majkusiak, W., Barcz, E., Vaginal excision of the sub-urethral sling: analysis of indications, safety and outcome, Archives of Medical Science, 11, 982–8, 2015</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes not presented to extract Referred for OAB (and other reasons)</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">George, A., Mattingly, M., Woodman, P., Hale, D., Recurrence of prolapse after transvaginal mesh excision, Female Pelvic Medicine & Reconstructive SurgeryFemale pelvic med, 19, 202–5, 2013</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevant outcomes not presented in paper</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hammett,J., Peters,A., Trowbridge,E., Hullfish,K., Short-term surgical outcomes and characteristics of patients with mesh complications from pelvic organ prolapse and stress urinary incontinence surgery, International Urogynecology Journal and Pelvic Floor Dysfunction, 25, 465–470, 2014</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women referred due to pain Outcomes not relevant</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hokenstad, E. D., El-Nashar, S. A., Blandon, R. E., Occhino, J. A., Trabuco, E. C., Gebhart, J. B., Klingele, C. J., Health-related quality of life and outcomes after surgical treatment of complications from vaginally placed mesh, Female Pelvic Medicine & Reconstructive SurgeryFemale pelvic med, 21, 176–80, 2015</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jambusaria, L. H., Heft, J., Reynolds, W. S., Dmochowski, R., Biller, D. H., Incontinence rates after midurethral sling revision for vaginal exposure or pain, American Journal of Obstetrics and Gynecology, 215, 764.e1–764.e5, 2016</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Revision surgery due to pain or mesh exposure</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kohli, N., Walsh, P. M., Roat, T. W., Karram, M. M., Mesh erosion after abdominal sacrocolpopexy, Obstetrics and Gynecology, 92, 999–1004, 1998</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No complication data, just numbers of erosion/extrusion</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Bacsu, C., Zimmern, P. E., Meshology: A fast-growing field involving mesh and/or tape removal procedures and their outcomes, Expert Review of Medical Devices, 12, 201–216, 2015</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative literature review</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Dillon, B., Lemack, G., Gomelsky, A., Zimmern, P., Transvaginal mesh kits - How “serious” are the complications and are they reversible?, Urology, 81, 43–48, 2013</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes not relevant</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Zimmern, P. E., Management of complications of mesh surgery, Current Opinion in Urology, 25, 284–291, 2015</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Narrative literature reveiw</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Marcus-Braun,N., Theobald,P.V., Mesh removal following transvaginal mesh placement: A case series of 104 operations, International urogynecology journal and pelvic floor dysfunction, 21, 423430, 2010</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Miklos, J. R., Chinthakanan, O., Moore, R. D., Karp, D. R., Nogueiras, G. M., Davila, G. W., Indications and Complications Associated with the Removal of 506 Pieces of Vaginal Mesh Used in Pelvic Floor Reconstruction: A Multicenter Study, Surgical Technology International, 29, 185–189, 2016</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Only presents data on type of mesh removal, no complication data</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Misrai,V., Roupret,M., Xylinas,E., Cour,F., Vaessen,C., Haertig,A., Richard,F., Chartier-Kastler,E., Surgical resection for suburethral sling complications after treatment for stress urinary incontinence, Journal of Urology, 181, 2198–2202, 2009</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review of sling surgery, no relevant articles</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pickett, S. D., Barenberg, B., Quiroz, L. H., Shobeiri, S. A., O’Leary, D. E., The significant morbidity of removing pelvic mesh from multiple vaginal compartments, Obstetrics and gynecology, 125, 1418–1422, 2015</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No outcomes of interest reported</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rac, G., Greiman, A., Rabley, A., Tipton, T. J., Chiles, L. R., Freilich, D. A., Rames, R., Cox, L., Koski, M., Rovner, E. S., Analysis of Complications of Pelvic Mesh Excision Surgery Using the Clavien-Dindo Classification System, Journal of Urology, 19, 19, 2017</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No outcomes reported of relevance</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ramart, P., Ackerman, A. L., Cohen, S. A., Kim, J. H., Raz, S., The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications, Urology, 106, 203–209, 2017</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Referred for pain not UI Relevant outcomes not reported</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ren,Y., Hong,L., Xu,E.X., Qi,X.Y., Mesh erosion after pelvic reconstructive surgeries, Saudi Medical Journal, 31, 180–184, 2010</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study on pop surgery, not surgery for complications</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Renezeder,K., Skala,C.E., Albrich,S., Koelbl,H., Naumann,G., Complications following the use of alloplastic materials in urogynecological surgery, European Journal of Obstetrics, Gynecology, and Reproductive Biology, 158, 354–357, 2011</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Shaw, J., Wohlrab, K., Rardin, C., Recurrence of stress urinary incontinence after midurethral sling revision: A retrospective cohort study, Female Pelvic Medicine and Reconstructive Surgery, 23, 184–187, 2017</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample referred for various mesh complications</td></tr><tr><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Singla, N., Aggarwal, H., Foster, J., Alhalabi, F., Lemack, G. E., Zimmern, P. E., Management of Urinary Incontinence Following Suburethral Sling Removal, Journal of Urology, 198, 644–649, 2017</td><td headers="hd_h_ch12.appk.tab3_1_1_1_1 hd_b_ch12.appk.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Referred due to pain</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appktab4"><div id="ch12.appk.tab4" class="table"><h3><span class="label">Table 38</span><span class="title">Excluded clinical studies with reasons for exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appk.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appk.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appk.tab4_1_1_1_1" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Excluded studies - What are the most effective management options for bowel symptoms after mesh surgery?</th></tr></thead><tbody><tr><th headers="hd_h_ch12.appk.tab4_1_1_1_1" id="hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th headers="hd_h_ch12.appk.tab4_1_1_1_1" id="hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for Exclusion</th></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Arunachalam, D., Hale, D. S., Heit, M. H., Posterior Compartment Surgery Provides No Differential Benefit for Defecatory Symptoms before or after Concomitant Mesh-Augmented Apical Suspension, Female Pelvic Medicine and Reconstructive Surgery, 24, 183–187, 2018</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant intervention.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Aungst,M.J., Friedman,E.B., von Pechmann,W.S., Horbach,N.S., Welgoss,J.A., De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair, American Journal of Obstetrics and Gynecology, 201, 73–77, 2009</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No relevant outcomes.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Badrek-Al Amoudi, A. H., Greenslade, G. L., Dixon, A. R., How to deal with complications after laparoscopic ventral mesh rectopexy: lessons learnt from a tertiary referral centre, Colorectal Disease, 15, 707–12, 2013</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant outcomes.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Barski, D., Deng, D. Y., Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the Current Literature, BioMed Research International, 2015, 831285, 2015</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Choi, J. M., Nguyen, V., Khavari, R., Reeves, K., Snyder, M., Fletcher, S. G., Complex rectovaginal fistulas after pelvic organ prolapse repair with synthetic mesh: a multidisciplinary approach to evaluation and management, Female Pelvic Medicine & Reconstructive SurgeryFemale pelvic med, 18, 366–71, 2012</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Costantini, E., Zucchi, A., Lazzeri, M., Del Zingaro, M., Vianello, A., Porena, M., Managing mesh erosion after abdominal pelvic organ prolapse repair: ten years’ experience in a single center, Urologia Internationalis, 86, 419–23, 2011</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Tayrac, R., Geryaise, A., Chauveand, A., Fernandez, H., Tension-free polypropylene mesh for vaginal repair of anterior vaginal wall prolapse, Journal of Reproductive Medicine for the Obstetrician and Gynecologist, 50, 75–80, 2005</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dubuisson, J., Eperon, I., Dallenbach, P., Dubuisson, J. B., Laparoscopic repair of vaginal vault prolapse by lateral suspension with mesh, Archives of Gynecology & ObstetricsArch Gynecol Obstet, 287, 307–12, 2013</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population. Irrelevant intervention.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ellerkmann, M., Goldstein, D., Hoskey, K., Robotic-assisted laparoscopic intravesical resection of a polypropylene retropubic mid-urethral sling, Journal of minimally invasive gynecology, 22 (3 Supplement), S59, 2015</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fatton, B., Dwyer, P. L., Achtari, C., Tan, P. K., Bilateral extraperitoneal uterosacral vaginal vault suspension: a 2-year follow-up longitudinal case series of 123 patients, International Urogynecology Journal, 20, 427–34, 2009</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Faucheron, J. L., Voirin, D., Riboud, R., Waroquet, P. A., Noel, J., Laparoscopic anterior rectopexy to the promontory for full-thickness rectal prolapse in 175 consecutive patients: short- and long-term follow-up, Diseases of the Colon & RectumDis Colon Rectum, 55, 660–5, 2012</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants. Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fengler,S.A., Pearl,R.K., Prasad,M.L., Orsay,C.P., Cintron,J.R., Hambrick,E., Abcarian,H., Management of recurrent rectal prolapse, Diseases of the Colon and Rectum, 40, 832–834, 1997</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Greiman,A., Kielb,S., Revisions of mid urethral slings can be accomplished in the office, Journal of Urology, 188, 190–193, 2012</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Herschorn, S., Urethrovaginal fistula repair-long-term outcomes, Neurourology and urodynamics, 36, S85, 2017</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant intervention.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hubb, A., Sink, N. J., Wood, S. C., Veronikis, D. K., Vaginal mesh explants: An analysis of implant type, patient symptomatology, and previous mesh revisions, Female Pelvic Medicine and Reconstructive Surgery, 22 (5 Supplement 1), S143-S144, 2016</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hurtado, E. A., Appell, R. A., Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center’s experience, International Urogynecology Journal, 20, 11–7, 2009</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jarrett, M. E., Matzel, K. E., Stosser, M., Baeten, C. G., Kamm, M. A., Sacral nerve stimulation for fecal incontinence following surgery for rectal prolapse repair: a multicenter study, Diseases of the Colon & Rectum, 48, 1243–8, 2005</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kowalik, C. R., Lakeman, M. M. E., Oryszczyn, J. E., Roovers, J. P. W. R., Reviewing Patients Following Mesh Repair; The Benefits, Gynecologic and Obstetric Investigation, 82, 575–581, 2017</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, C. H., Ku, J. Y., Lee, K., Lee, J. Z., Shin, D. G., Clinical Application of a Transurethral Holmium Laser Excision of Exposed Polypropylene Mesh at Lower Urinary Tract: Single Surgeon Experience with Long-term Follow-up, Female Pelvic Medicine and Reconstructive Surgery, 24, 26–31, 2018</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee, D., Bacsu, C., Zimmern, P. E., Meshology: A fast-growing field involving mesh and/or tape removal procedures and their outcomes, Expert Review of Medical Devices, 12, 201–216, 2015</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MacDonald, S., Terlecki, R., Costantini, E., Badlani, G., Complications of Transvaginal Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence: Tips for Prevention, Recognition, and Management, European Urology Focus, 2, 260–267, 2016</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mathew, M. J., Parmar, A. K., Reddy, P. K., Mesh erosion after laparoscopic posterior rectopexy: A rare complication, Journal of Minimal Access Surgery, 10, 40–1, 2014</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">McCoy, O., Vaughan, T., Nickles, S. W., Ashley, M., MacLachlan, L. S., Ginsberg, D., Rovner, E., Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal, Journal of Urology, 196, 484–9, 2016</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medendorp, A., Chaudhry, Z., Oliver, J., Wood, L., Kim, J. H., Baxter, Z., Raz, S., Autologous fascia sacrocolpopexy after complete removal of sacrocolpopexy mesh, Journal of urology, 197 (4 Supplement 1), e355-e356, 2017</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nazemi, T. M., Kobashi, K. C., Complications of grafts used in female pelvic floor reconstruction: Mesh erosion and extrusion, Indian Journal of UrologyIndian J, 23, 153–60, 2007</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nguyen, J. N., Burchette, R. J., Outcome after anterior vaginal prolapse repair: a randomized controlled trial, Obstetrics & Gynecology, 111, 891–8, 2008</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population. Irrelevant intervention.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ow, L. L., Lim, Y. N., Dwyer, P. L., Karmakar, D., Murray, C., Thomas, E., Rosamilia, A., Native tissue repair or transvaginal mesh for recurrent vaginal prolapse: what are the long-term outcomes?, International Urogynecology Journal, 27, 1313–20, 2016</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population. Irrelevant intervention.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quiroz, L. H., Gutman, R. E., Fagan, M. J., Cundiff, G. W., Partial colpocleisis for the treatment of sacrocolpopexy mesh erosions.[Erratum appears in Int Urogynecol J Pelvic Floor Dysfunct. 2008 Feb;19(2):307], International Urogynecology Journal, 19, 261–6, 2008</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Robert-Yap, J., Zufferey, G., Rosen, H., Lechner, M., Wunderlich, M., Roche, B., Sacral nerve modulation in the treatment of fecal incontinence following repair of rectal prolapse, Diseases of the Colon & RectumDis Colon Rectum, 53, 428–31, 2010</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ross, A. H., Thomson, J. P., Management of infection after prosthetic abdominal rectopexy (Wells’ procedure), British Journal of SurgeryBr J Surg, 76, 610–2, 1989</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Schultz, I., Mellgren, A., Dolk, A., Johansson, C., Holmstrom, B., Long-term results and functional outcome after Ripstein rectopexy, Diseases of the Colon & RectumDis Colon Rectum, 43, 35–43, 2000</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant intervention.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Setti Carraro, P., Nicholls, R. J., Postanal repair for faecal incontinence persisting after rectopexy, British Journal of Surgery, 81, 305–7, 1994</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Shah, H. N., Badlani, G. H., Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review, Indian Journal of Urology, 28, 129–53, 2012</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Skala, C. E., Renezeder, K., Albrich, S., Puhl, A., Laterza, R. M., Naumann, G., Koelbl, H., Mesh complications following prolapse surgery: Management and outcome, European Journal of Obstetrics Gynecology and Reproductive Biology, 159, 453–456, 2011</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants. Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Toz, E., Sahin, C., Apaydin, N., Ozcan, A., Taner, C. E., Functional outcomes of polypropylene midurethral sling resection for treatment of mesh exposure/extrusion: Does it lead to a relapse of incontinence?, Ginekologia Polska, 86, 531–6, 2015</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants. Irrelevant population.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tranchart, H., Valverde, A., Goasguen, N., Gravie, J. F., Mosnier, H., Conservative treatment of intrarectal mesh migration after ventral laparoscopic rectopexy for rectal prolapse, International Journal of Colorectal Disease, 28, 1563–6, 2013</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Too few participants.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Warembourg, S., Labaki, M., de Tayrac, R., Costa, P., Fatton, B., Reoperations for mesh-related complications after pelvic organ prolapse repair: 8-year experience at a tertiary referral center, International Urogynecology Journal, 1–13, 2017</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Small proportion of cohort had bowel complications.</td></tr><tr><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zambon, J. P., Badlani, G. H., Vaginal Mesh Exposure Presentation, Evaluation, and Management, Current Urology Reports, 17 (9) (no pagination), 2016</td><td headers="hd_h_ch12.appk.tab4_1_1_1_1 hd_b_ch12.appk.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Irrelevant population.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appltab1"><div id="ch12.appl.tab1" class="table"><h3><span class="label">Table 39</span><span class="title">Research recommendation rationale</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appl.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appl.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Research question</th><th id="hd_h_ch12.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">What is the effectiveness of pain management in women presenting with chronic pain 3 months after mesh surgery?</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance to ‘patients’ or the population</td><td headers="hd_h_ch12.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">There is insufficient evidence to guide women and their clinicians on the likelihood of pain improvement or resolution after mesh removal and there are significant risks associated with mesh removal surgery</td></tr><tr><td headers="hd_h_ch12.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to NICE guidance</td><td headers="hd_h_ch12.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This is an important area of the guideline for which no evidence was found</td></tr><tr><td headers="hd_h_ch12.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to the NHS</td><td headers="hd_h_ch12.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chronic pain and sexual dysfunction after mesh surgery can be debilitating and have a severe impact on a woman’s quality of life. The outcome would be that women can be offered the most effective treatment in a timely manner, if they present with new or persistent symptoms</td></tr><tr><td headers="hd_h_ch12.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">National priorities</td><td headers="hd_h_ch12.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">High</td></tr><tr><td headers="hd_h_ch12.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Current evidence base</td><td headers="hd_h_ch12.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Poor</td></tr><tr><td headers="hd_h_ch12.appl.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Equality</td><td headers="hd_h_ch12.appl.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appltab2"><div id="ch12.appl.tab2" class="table"><h3><span class="label">Table 40</span><span class="title">Research recommendation modified PICO table v1</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appl.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appl.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Criterion</th><th id="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Explanation</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</td><td headers="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women presenting with pain after mesh surgery (high priority).</td></tr><tr><td headers="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td><td headers="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Surgical removal alone.</td></tr><tr><td headers="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator</td><td headers="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specialist pain management or specialist pain management then surgery if pain fails to resolve after conservative management</td></tr><tr><td headers="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</td><td headers="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain improvement, quality of life, secondary complications from surgery.</td></tr><tr><td headers="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</td><td headers="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT level, if feasible. (Can be cross-over) e.g. Nothing then surgery + pain management then surgery (to see how many with pain management went on to have surgery). Pain management = meds, CBT, specialist pain management.</td></tr><tr><td headers="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Timeframe</td><td headers="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 months</td></tr><tr><td headers="hd_h_ch12.appl.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Additional information</td><td headers="hd_h_ch12.appl.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appltab3"><div id="ch12.appl.tab3" class="table"><h3><span class="label">Table 41</span><span class="title">Research recommendation modified PICO table v2 (deprioritised)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appl.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appl.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Criterion</th><th id="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Explanation</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</td><td headers="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women presenting with pain after mesh surgery.</td></tr><tr><td headers="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td><td headers="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Surgery to complete mesh removal. Complete mesh removal</td></tr><tr><td headers="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator</td><td headers="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Partial mesh removal.</td></tr><tr><td headers="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</td><td headers="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain improvement, quality of life</td></tr><tr><td headers="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</td><td headers="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT. Could be crossover if partial removal the goes on to have complete removal?</td></tr><tr><td headers="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Timeframe</td><td headers="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 months</td></tr><tr><td headers="hd_h_ch12.appl.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Additional information</td><td headers="hd_h_ch12.appl.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appltab4"><div id="ch12.appl.tab4" class="table"><h3><span class="label">Table 42</span><span class="title">Research recommendation modified PICO table v3 (deprioritised)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appl.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appl.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Criterion</th><th id="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Explanation</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</td><td headers="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women presenting with dyspareunia after mesh surgery.</td></tr><tr><td headers="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td><td headers="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mesh removal.</td></tr><tr><td headers="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator</td><td headers="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Vaginal oestrogen, vaginal dilators and/or psychosexual counselling</td></tr><tr><td headers="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</td><td headers="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Improvement in dyspareunia, quality of life</td></tr><tr><td headers="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</td><td headers="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT although could be crossover if vaginal oestrogen goes on to have mesh removal</td></tr><tr><td headers="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Timeframe</td><td headers="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 months</td></tr><tr><td headers="hd_h_ch12.appl.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Additional information</td><td headers="hd_h_ch12.appl.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch12appltab5"><div id="ch12.appl.tab5" class="table"><h3><span class="label">Table 43</span><span class="title">Research recommendation modified PICO table v4 (deprioritised)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577729/table/ch12.appl.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch12.appl.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Criterion</th><th id="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Explanation</th></tr></thead><tbody><tr><td headers="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</td><td headers="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Women presenting with pain after mesh surgery.</td></tr><tr><td headers="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td><td headers="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physiotherapy or talking therapy.</td></tr><tr><td headers="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator</td><td headers="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain medicines.</td></tr><tr><td headers="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</td><td headers="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Improvement in pain, quality of life.</td></tr><tr><td headers="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</td><td headers="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT</td></tr><tr><td headers="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Timeframe</td><td headers="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 months</td></tr><tr><td headers="hd_h_ch12.appl.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Additional information</td><td headers="hd_h_ch12.appl.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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