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How is pain associated with pelvic mesh implants measured? Refinement of the construct and a scoping review of current assessment tools.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Aspell, Jane E 
Lee, Michael C 
Thiruchelvam, Nikesh 

Abstract

BACKGROUND: Recommendations for the management of pain related to pelvic mesh implants are still under development. One limitation that has impeded progress in this area is that mesh-related pain has not been consistently defined or measured. Here, we reviewed the ways in which pain associated with pelvic mesh implants has been measured, and mapped the ways in which these existing measures capture the construct. METHODS: First, we reviewed existing accounts of the pain associated with pelvic mesh implants to develop a multifaceted construct definition, which includes aspects related to pain intensity, timing, body location, phenomenological qualities, impact/interference with daily living, and patient expectations and beliefs. Next, we reviewed the ways that the construct has been measured in the extant literature. RESULTS: Within 333 eligible studies, 28 different assessments of pain associated with pelvic mesh were identified, and 61% of studies reported using more than one measurement tool. Questionnaire measures included measures designed to assess urological and/or pelvic symptoms, generic measures and unvalidated measures. We did not identify any validated questionnaire measures designed to assess pain associated with pelvic mesh implants. The phenomenological, location, and expectation/belief components of the construct were not captured well by the identified questionnaire measures, and there is no evidence that any of the identified measures have appropriate psychometric properties for the assessment of pain related to pelvic mesh implants. CONCLUSIONS: We recommend further qualitative research regarding women's experiences of pelvic mesh-related pain assessment, and the development of a condition-specific patient reported outcome measure.

Description

Funder: The Urology Foundation

Keywords

Assessment, Pain, Pelvic mesh, Pelvic organ prolapse, Psychometric, Stress urinary incontinence, Female, Gynecologic Surgical Procedures, Humans, Pelvic Organ Prolapse, Pelvic Pain, Surgical Mesh, Surveys and Questionnaires, Treatment Outcome

Journal Title

BMC Womens Health

Conference Name

Journal ISSN

1472-6874
1472-6874

Volume Title

22

Publisher

Springer Science and Business Media LLC