Does monofilament polypropylene mesh contract in the posterior pelvic compartment (original) (raw)
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Long-term outcome of synthetic mesh use in Iranian women with genital prolapse
Urology journal, 2019
PURPOSE To evaluate the long-term outcome of synthetic mesh use in the treatment of women with Pelvic organ prolapse (POP). MATERIALS AND METHODS We evaluated the outcome of synthetic mesh implantation by vaginal surgery method in 153 women (mean age of 53.66±9.31 years) with POP grade >2 in the anterior compartment. Demographic findings, baseline symptoms as well as subjective and objective outcome were recorded during the follow-up period of 36.89±11.33 months. Results: POP relapse occurred in 3.3% indicative of 96.7% anatomical success rate. Patients' common baseline findings were frequency (72.5%), stress and urge incontinence (59.5% and 47.7%). Subjective outcome were vaginal pain (13.7%), dyspareunia (9.2%) and tension feeling (8.5%), while objective outcomes were mesh exposure (3.9%), urge incontinence (11.1%) and vaginal infection (1.3%). Stress incontinence was completely treated following surgery. There was significant improvement in dyspareunia, vaginal pain, urg...
Analysis of outcomes of single polypropylene mesh in total pelvic floor reconstruction
Neurourology and Urodynamics, 2007
Aims: A 2.5-year outcome analysis was performed on patients who underwent transvaginal repair of total pelvic organ prolapse with single polypropylene mesh. A description of the repair technique using a tension-free 4-point ¢xation is also reviewed. Methods: After proper vaginal dissection, a specially fashioned ''H'' shaped polypropylene mesh is positioned and ¢xed at 4-points. With a single piece of mesh, the anterior arms provide mid-urethral and bladder neck support, the mid-portion of the mesh corrects anterior compartment defects, and the posterior arms aid in vaginal vault suspension. Initially, bone anchors were utilized for anterior ¢xation, but currently a tension-free method is used. A retrospective analysis using chart review was performed on 96 patients who underwent this procedure from January 2000 to June 2005. Additional information was gathered by a telephone survey using a questionnaire. Statistical analysis was performed using Student's t-test, with Sigma Stat 1 . Results: Seventy-six patients (79%) were available with a mean follow-up time of 30.7 AE 1.7 months and mean age of 69.3 AE 11.3. Among those with follow-up, 36 patients (47.4%) underwent concurrent hysterectomies. Recurrence of prolapse was reported by four patients (5.2%). Sixty-eight patients (89%) were completely dry or almost dry, de¢ned as an occasional leak. For those with preoperative incontinence (n ¼ 36), average pad use per day decreased signi¢cantly from 2.1 AE 0.4 to 0.8 AE 0.2 (P < 0.005) postoperatively. Twelve patients (15.7%) reported of de novo urgency. Six patients required reoperation including excision of vaginal mesh erosion (2), uretholysis for obstruction (1), removal of palpable vaginal suture (1), and recurrent SUI (2). Among the 21 patients who are sexually active, 19 denied any dyspareunia (90.4%). Patient satisfaction was high, as the mean value was 7.9 AE 0.3 on a scale of 1 (least satis¢ed) to 10 (most satis¢ed). Conclusions: Transvaginal repair of complete pelvic prolapse using polypropylene mesh is a safe and e⁄cacious option, with minimal recurrence of prolapse and SUI. While two patients had vaginal erosions, no urethral or bladder erosions occurred. Patient satisfaction was overall favorable. Neurourol. Urodynam. 26: 53^58, 2007. ß 2006
International Neurourology Journal, 2018
To evaluate the safety and efficacy of a surgical polypropylene mesh for correction of anterior vaginal prolapse, with or without apical defects, by providing simultaneous reinforcement at the anterior and apical aspects of the vagina with a single-incision approach. Methods: This was a prospective, multicenter, single-arm study involving women with baseline stage ≥ 2 anterior and/or apical vaginal wall prolapse according to the Pelvic Organ Prolapse Quantification (POP-Q) system. The primary endpoint was defined as achievement of POP-Q stage ≤ 1 status. Additionally, patient-reported outcomes were assessed using the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS). The device under evaluation was Calistar A, which is fixed posteriorly to the sacrospinous ligaments with a novel tissue-anchoring system (TAS) and anteriorly to the obturator internus muscles. Postoperative follow-ups were scheduled at 7 days and at 6, 12, and 24 months. Results: Ninety-seven women were treated and assessed for the primary outcome. They were followed for up to 2 years (n = 43), with a median of 12 months. Objective cure was achieved in 86 of the 97 patients (88.7%) (P < 0.0005). The mean reduction in the ICIQ-VS scores was in the range of 70%-90% for every time point (P < 0.05). No bleeding or surgical revision was reported. Mesh exposure occurred in 7 patients (7.2%), urinary retention in 5 (5.2%), de novo dyspareunia in 3 (3.1%), and urinary tract infections in 7 (7.2%). Conclusions: This midterm follow-up showed that apical and anterior vaginal reinforcement with a polypropylene implant fixed with a TAS provided good anatomical correction, with no major complications.
Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future?
Biomedicines
Background: Polypropylene (PP) pelvic mesh is a synthetic mesh made of PP polymer used to treat pelvic organ prolapse (POP). Its use has become highly controversial due to reports of serious complications. This research critically reviews the current management options for POP and PP mesh as a viable clinical application for the treatment of POP. The safety and suitability of PP material were rigorously studied and critically evaluated, with consideration to the mechanical and chemical properties of PP. We proposed the ideal properties of the ‘perfect’ synthetic pelvic mesh with emerging advanced materials. Methods: We performed a literature review using PubMed/Medline, Embase, Cochrane Library (Wiley) databases, and ClinicalTrials.gov databases, including the relevant keywords: pelvic organ prolapse (POP), polypropylene mesh, synthetic mesh, and mesh complications. Results: The results of this review found that although PP is nontoxic, its physical properties demonstrate a signific...
Abstract Objective of the study: To know the efficacy of transvaginal mesh repair augmented by synthetic polypropylene mesh for pelvic organ prolapse with objective and subjective result of the procedure. Material and methods: Evidence was gathered mostly about transvaginal synthetic polypropylene mesh using the search terms Transvaginal mesh, urinary incontinence, Mesh -complication, anterior prolapse, posterior prolapse, pelvic organ prolapse, vault prolapse, and mesh erosion-From April 2008 to March 2013. Online search range: Pub Med, Medline, RCT, Embase, database, Retrospective study and prospective study. Result: In vaginal Prolapse surgery, graft or mesh is used more frequently than traditional repairs, which has high failure rates. Vaginal approach of mesh placement and suspension of the upper part of the vagina is seen to be more appropriate and successful, showing effects similar to that of the invasive abdominal approach. Because of its lower failure rates it is recently supported by Cochrane review as well. To make such kinds of surgeries easier, more standard and least invasive vaginal kits are being upgraded. It is said that every surgeon can perform the procedure with mesh kits easily, but it is not so. It needs advance pelvic surgery skills, a lot to understand and the limitations of the technique as well. This current paper focuses the needs for the development of the kit, how to use it, results and complications till date and the techniques how to overcome the complications. Before recommending the technique for general use in all Prolapse patients, a lot of things like investigation on proper patient selection, continue research on graft composition, techniques that minimize complications of needle passes or mesh placement should be understood thoroughly. Apart from these we still should have more surgical skills to perform the procedures, to reduce complications and increase better results. Conclusion: Transvaginal repair using a synthetic polypropylene transvaginal mesh is a feasible and efficient procedure for the treatment of pelvic organ prolapse with less significant complications. Monofilament macro porous synthetic polypropylene mesh is effective, due to its low risk of infection and foreign body reaction. Proper patient selection is the best way to avoid unnecessary complications. Keywords: Pelvic organ prolapse, transvaginal mesh, synthetic polypropylene mesh, mesh complication
Trends in use of surgical mesh for pelvic organ prolapse
American Journal of Obstetrics and Gynecology, 2013
OBJECTIVE: Limited data exist on the rates of pelvic organ prolapse procedures utilizing mesh. The objective of this study was to examine trends in vaginal mesh prolapse procedures (VMs), abdominal sacrocolpopexy (ASC), and minimally invasive sacrocolpopexy (MISC) from 2005 to 2010.