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Mesh complications pelvic floor prolapse

Dongmei Wei, Ping Wang, Xiaoyu Niu, Xia Zhao
AIM: To compare total pelvic floor reconstruction with vaginal mesh (TVM) and laparoscopic uterus/sacrocolpopexy (LSC) for the treatment of pelvic organ prolapse (POP). METHODS: Six hundred and seventy patients with POP stage 3 and 4 underwent LSC (n = 350) or TVM (n = 320) at the West China Second Hospital, Sichuan University between January 2011 and December 2016. Retrospective analysis was done to compare the POP-Q value before operation and 6 months, 5 years after operation, also compare the, patient global impression of change (PGI-C), pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7)...
January 16, 2019: Journal of Obstetrics and Gynaecology Research
Yu-Wei Chang, Fei-Chi Chuang, Ling-Ying Wu, Tsai-Hwa Yang, Fu-Tsai Kung, Kuan-Hui Huang
OBJECTIVE: The aim of this study was to assess the efficacy and clinical outcomes of pelvic floor reconstruction with transvaginal mesh of the Uphold™ Vaginal Support System (Boston Scientific Corporation). MATERIALS AND METHODS: This retrospective study reviewed the medical records of patients with pelvic organ prolapse stage 3 or 4 who underwent pelvic reconstructive surgery with transvaginal mesh of the Uphold™ Vaginal Support System from January 2015 to March 2017...
January 2019: Taiwanese Journal of Obstetrics & Gynecology
Jens-Erik Walter
Vaginal vault prolapse afflicts millions of women and evokes significant psychosocial and pelvic floor dysfunction. The risk factors and modalities of conservative management are discussed in this study. There remains controversy in the optimal surgical management. This review serves to study the clinical conundrum of the decision-making process to utilize the mesh and the approach. In-depth evaluation of mesh-related postsurgical complications as compared to those associated with the native tissue is explored...
January 2019: Best Practice & Research. Clinical Obstetrics & Gynaecology
Adrienne L K Li, Patricia E Lee
OBJECTIVE: This study sought to determine patients' background knowledge and attitudes towards the use of mesh in pelvic floor reconstructive surgery (PFRS) and the effect of medical consultation on their knowledge and attitudes about mesh use. METHODS: New urogynecology patients seen for pelvic organ prolapse and/or stress urinary incontinence were asked to complete pre-consultation questionnaires involving 12 questions on demographics and knowledge, attitudes, and concerns about the use of vaginal mesh...
October 25, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Mahshid Vashaghian, Chantal M Diedrich, B Zandieh-Doulabi, A Werner, Theodoor H Smit, Jan-Paul Roovers
The extracellular matrix of fascia-like tissues is a resilient network of collagenous fibers that withstand the forces of daily life. When overstretched, the matrix may tear, with serious consequences like pelvic organ prolapse (POP). Synthetic implants can provide mechanical support and evoke a host response that induces new matrix production, thus reinforcing the fascia. However, there is considerable risk of scar formation and tissue contraction which result in severe complications. Matrix producing fibroblasts are both mechanosensitive and contractile; their behavior depends on the implant's surface texture and mechanical straining...
November 21, 2018: Acta Biomaterialia
Ivilina Pandeva, Helen Johnson, Mark Slack, Ashish Pradhan
Background: The adverse publicity surrounding the use of mesh for correction of pelvic organ prolapse has driven a renewed interest in native tissue repair. Established techniques used reusable instruments, while recent innovations have generally involved disposable equipment. Here, we compare outcomes between the two techniques used for sacrospinous ligament fixation for the correction of apical prolapse: Miya Hook (reusable) and Capio® (single-use) suturing devices. Methods: A prospective cohort study of women undergoing vaginal sacrospinous colpopexy or hysteropexy was undertaken...
2018: International Journal of Women's Health
Alpaslan Caliskan, Mehmet Ozeren, Klaus Goeschen
Introduction: High failure and recurrent prolapse remains an important issue for pelvic organ prolapse (POP) surgery. The posterior intravaginal slingplasty (PIVS) is a minimally invasive, transperineal technique providing level I support, by creating neo-sacrouterine ligaments using a mesh. In order to reduce the POP recurrence rate, achieve a safer apical support and thereby better functional outcomes, we attached PIVS tape to the sacrospinous ligament bilaterally and compared the anatomical and functional outcomes for our modified technique versus the original PIVS...
2018: Central European Journal of Urology
Emily R W Davidson, Tonya N Thomas, Erika J Lampert, Marie Fidela R Paraiso, Cecile A Ferrando
INTRODUCTION AND HYPOTHESIS: Hysterectomy can be performed during sacrocolpopexy, but there are limited studies comparing the effect of route of hysterectomy on adverse events. We hypothesized there would be no difference in adverse events or patient-reported outcomes in women who underwent minimally invasive sacrocolpopexy with either vaginal or supracervical hysterectomy. METHODS: This was a retrospective chart review with a cross-sectional survey component sent to all consenting patients...
October 18, 2018: International Urogynecology Journal
Martha Duraes, Laure Panel, Arnaud Cornille, Christophe Courtieu
OBJECTIVE: The aim of the study was to assess 5 years outcome of transvaginal single incision mesh surgery (SIMS) for anterior pelvic organ prolapse (POP). STUDY DESIGN: This was a prospective study including all patients from January 2009 to December 2012 who underwent SIMS for symptomatic anterior prolapse stage ≥2, according to POP Quantification (POP-Q). Symptoms and quality of life were assessed using validated questionnaires: Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact questionnaire (PFIQ-7), and Prolapse/ Incontinence Sexual Questionnaire (PISQ-12)...
November 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Sabiniano Roman, Naside Mangir, Lucie Hympanova, Christopher R Chapple, Jan Deprest, Sheila MacNeil
AIMS: Stress urinary incontinence and pelvic organ prolapse are very common conditions with a proportion of patients requiring implantation of synthetic materials for a durable repair. However increasing numbers of post-surgical complications have been reported related to the use of polypropylene meshes. One hypothesis for the adverse response is poor mechanical matching of the relatively stiff polypropylene mesh particularly as materials in the pelvic floor will need to cope with decades of distension as occurs with increase of intraabdominal pressure on coughing, laughing, or sneezing...
September 24, 2018: Neurourology and Urodynamics
Stephen Stonelake, Oliver Gee, David McArthur, Ingo Jester
BACKGROUND/PURPOSE: To review our early experience of laparoscopic ProTack™ rectopexy (LPR) in the management of full thickness rectal prolapse (FTRP) in children. METHODS: Prospective case series of patients undergoing LPR between 2013 and 2017. Full laparoscopic mobilization of the rectum was performed from the sacral promontory to the pelvic floor. 'Wings' of the lateral mesorectal peritoneum left attached to the rectum are then fixed to the sacral promontory using ProTack™...
October 2018: Journal of Pediatric Surgery
Lucie Hympánová, Rita Rynkevic, Sabiniano Román, Marina G M C Mori da Cunha, Edoardo Mazza, Manuel Zündel, Iva Urbánková, Monica R Gallego, Jakob Vange, Geertje Callewaert, Christopher Chapple, Sheila MacNeil, Jan Deprest
BACKGROUND: There is an urgent need to develop better materials to provide anatomical support to the pelvic floor without compromising its function. OBJECTIVE: Our aim was to assess outcomes after simulated vaginal prolapse repair in a sheep model using three different materials: (1) ultra-lightweight polypropylene (PP) non-degradable textile (Restorelle) mesh, (2) electrospun biodegradable ureidopyrimidinone-polycarbonate (UPy-PC), and (3) electrospun non-degradable polyurethane (PU) mesh in comparison with simulated native tissue repair (NTR)...
July 23, 2018: European Urology Focus
Femke van Zanten, Jan J van Iersel, Francis E Hartog, Karin I M Aalders, Egbert Lenters, Ivo A M J Broeders, Steven E Schraffordt Koops
STUDY OBJECTIVE: To prospectively evaluate the mesh exposure rate after robot-assisted laparoscopic pelvic floor surgery for the treatment of female pelvic organ prolapse (POP) in a large cohort. DESIGN: Prospective observational cohort study (Canadian Task Force classification II-2). SETTING: Two large teaching hospitals with a tertiary referral function for pelvic floor disorders. PATIENTS: Patients with symptomatic POP and simplified POP quantification (S-POP) stage ≥2...
June 30, 2018: Journal of Minimally Invasive Gynecology
Lin Li Ow, Yik N Lim, Joseph Lee, Christine Murray, Elizabeth Thomas, Alison Leitch, Anna Rosamilia, Peter L Dwyer
INTRODUCTION AND HYPOTHESIS: This study assessed the safety and efficacy of vaginal extraperitoneal uterosacral ligament suspension (VEULS) with anterior overlay mesh versus sacrocolpopexy (SCP) for posthysterectomy vault prolapse. METHODS: This was a multicenter randomized trial of women with posthysterectomy vault prolapse stage >2 according to the Pelvic Organ Prolapse Quantification (POP-Q) system. Primary outcome was a composite of no vaginal bulge symptoms, no anatomical recurrence in the anterior or apical compartment at or beyond the hymenal ring, and no surgical retreatment for prolapse 12 months postsurgery...
November 2018: International Urogynecology Journal
Claudia R Kowalik, Mariëlle M E Lakeman, Alyde T de Kraker, Jan Paul W R Roovers
INTRODUCTION AND HYPOTHESIS: Vaginal mesh surgery is subject of debate due to the impact of mesh-related complications on patient's lives. Not all of these complications are symptomatic. Restoration of the anatomy and improvement of pelvic floor function as a result may counter the experienced discomfort related to adverse events. We hypothesized that health-related quality of life (HR-QoL) is comparable in women after vaginal mesh surgery regardless of the presence or absence of a mesh-specific complication...
June 16, 2018: International Urogynecology Journal
Sissel Hegdahl Oversand, Anne C Staff, Ellen Borstad, Rune Svenningsen
INTRODUCTION AND HYPOTHESIS: Classical native-tissue techniques for pelvic organ prolapse (POP) repairs, such as the Manchester procedure (MP), have been revitalized because of vaginal mesh complications. However, there are conflicting opinions regarding sufficient apical (mid-compartment) support by the MP and concerns about the risk of dyspareunia. The aims of this study were therefore to investigate anatomical and patient-reported outcomes 1 year after MP. METHODS: Prospective cohort study of 153 females undergoing an MP for anterior compartment POP between October 2014 and June 2016...
August 2018: International Urogynecology Journal
Alex Mowat, Declan Maher, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Christopher Maher
BACKGROUND: Posterior vaginal wall prolapse (also known as 'posterior compartment prolapse') can cause a sensation of bulge in the vagina along with symptoms of obstructed defecation and sexual dysfunction. Interventions for prevention and conservative management include lifestyle measures, pelvic floor muscle training, and pessary use. We conducted this review to assess the surgical management of posterior vaginal wall prolapse. OBJECTIVES: To evaluate the safety and effectiveness of any surgical intervention compared with another surgical intervention for management of posterior vaginal wall prolapse...
March 5, 2018: Cochrane Database of Systematic Reviews
Julio Bissoli, Homero Bruschini
Pelvic organ prolapse (POP) has borrowed principles of treatment from hernia repair and in the last two decades we saw reinforcement materials to treat POP with good outcomes in terms of anatomy but with alarming complication rates. Polypropylene meshes to specifically treat POP have been withdrawn from market by manufactures and a blank space was left to be filled with new materials. Macroporous monofilament meshes are ideal candidates and electrospinning emerged as a reliable method capable of delivering production reproducibility and customization...
2018: International Journal of Biomaterials
Jean-Philippe Lucot, Michel Cosson, Georges Bader, Philippe Debodinance, Cherif Akladios, Delphine Salet-Lizée, Patrick Delporte, Denis Savary, Philippe Ferry, Xavier Deffieux, Sandrine Campagne-Loiseau, Renaud de Tayrac, Sébastien Blanc, Sandrine Fournet, Arnaud Wattiez, Richard Villet, Marion Ravit, Bernard Jacquetin, Xavier Fritel, Arnaud Fauconnier
BACKGROUND: Laparoscopic mesh sacropexy (LS) or transvaginal mesh repair (TVM) are surgical techniques used to treat cystoceles. Health authorities have highlighted the need for comparative studies to evaluate the safety of surgeries with meshes. OBJECTIVE: To compare the rate of complications, and functional and anatomical outcomes between LS and TVM. DESIGN, SETTING, AND PARTICIPANTS: Multicenter randomized controlled trial from October 2012 to April 2014 in 11 French public hospitals...
August 2018: European Urology
Qinyi Zhu, Huimin Shu, Guiqiang Du, Zhiyuan Dai
BACKGROUND: Pelvic organ prolapse (POP) is a common disease in women. The aim of this research was to evaluate the safety, efficacy and complication of transvaginal modified sacrospinous ligament fixation with mesh using for the treatment of vaginal vault prolapse. MATERIALS AND METHODS: This was a prospective study including information from 60 symptomatic women with anterior-apical pelvic floor prolapse. The patients underwent transvaginal modified sacrospinous ligament fixation combined with anterior vaginal wall mesh between May 2014 and Sep 2015...
April 2018: International Journal of Surgery
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