Wire mesh exposed data

We retrospectively reviewed 501 women who underwent transvaginal polypropylene mesh-augmented anterior repair between January 2019 and January 2024; 43 women (8.6%) developed vaginal mesh exposure during follow-up. Age, type 2 diabetes mellitus, previous pelvic floor reconstructive surgery, and concomitant vaginal hysterectomy were entered into a multivariable logistic regression model. The cohort was randomly divided into a 70% training set and a 30% internal validation set.

Model discrimination was assessed using receiver operating characteristic curves, calibration was evaluated using calibration plots and 1,000 bootstrap resamples, and clinical utility was explored using decision curve analysis. Results: Older age (odds ratio [OR] per year, 1.172; 95% confidence interval [CI], 1.099-1.249), type 2 diabetes mellitus (OR, 7.990; 95% CI, 2.931-21.783), previous pelvic floor surgery (OR, 8.218; 95% CI, 3.046-22.173), and concomitant vaginal hysterectomy (OR, 13.806; 95% CI, 5.142-37.073) were associated with mesh exposure (all P<0.001).

The area under the curve was 0.959 (95% CI, 0.932-0.986) in the training set and 0.924 (95% CI, 0.874-0.972) in the internal validation set. The bootstrap-corrected calibration curve in the training set had a mean absolute error of 0.017. Decision curve analysis suggested a positive net benefit across threshold probabilities of approximately 0.10-0.35.

Conclusions: Four readily available clinical variables were associated with vaginal mesh exposure, and the resulting nomogram showed promising internal performance. Because the study was retrospective, single-center, and based on only 43 events, external validation and further model updating are required before routine clinical use.