• Peter S Finamore, Krystal Hunter, Howard B Goldstein, Babak Vakili, and Adam S Holzberg.
• Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics/Gynecology, Winthrop University Hospital, 259 First Street, Mineola, NY 11501, USA. pfinamore@winthrop.org
• Arch. Gynecol. Obstet. 2011 Sep 1; 284 (3): 659-62.

UnlabelledDoes local injection with lidocaine plus epinephrine prior to vaginal reconstructive surgery with synthetic mesh affect exposure rates? A retrospective comparison.PurposeTo determine if local injection, prior to incision with lidocaine plus epinephrine (L + E) influences the rate of mesh exposure in the early postoperative period following synthetic mesh augmented vaginal reconstructive surgery (MAVR).MethodsWe performed a chart review over an 18-month period of patients who underwent MAVR. The presence of mesh exposure at the 3-month postoperative visit, demographic data and whether or not L + E was used to hydrodissect was recorded. Statistical analysis was performed to determine whether hydrodissection influenced erosion rates.ResultsA total of 143 meshes were placed, hydrodissection with L + E was used in 78 cases and was not in the remaining 65 cases. There were 10 (7.0% 10/143) total erosions at the 3-month postoperative visit, 6 (7.7%; 6/78) in the group that got L + E and 4 (6.2%; 4/65) in the group that did not get local injection. This difference was not significant (p = 0.740, OR 1.54 95% CI 0.41-5.76). There was no difference between the two groups in terms of age, presence of diabetes, concurrent incontinence repair or estimated blood loss.ConclusionMesh exposure is a known complication of MAVR. Our study suggests that local injection with L + E prior to vaginal surgery does not influence exposure rates.

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