Changes in the length of implanted mesh after reconstructive surgery of the anterior vaginal wall


Authors: K. Švabík 1;  A. Martan 1;  J. Mašata 1;  R. El-Haddad 1;  M. Pavlikova 2
Authors‘ workplace: Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc. 1;  EuroMISE Centrum, Ústav informatiky Akademie věd ČR v. v. i., vedoucí prof. RNDr. J. Zvárová, DrSc. 2
Published in: Čes. Gynek.2010, 75, č. 2 s. 132-135

Overview

Objective:
To evaluate and quantify early and late changes in mesh length after anterior vaginal repair with implants with ultrasound.

Type of study:
Prospective interventional study.

Methods:
Ultrasound assessment of 35 patient randomized in two groups both with Gynemesh insertion. In one group with Gynemesh Prolift anterior kit and second group with individualized size of the Gynemesh. Ultrasound measurement of the mesh in sagittal plane was performed postoperative day 4 and after 3-4 month. Measured values were put in proportions, together with the original size of the mesh. Results are expressed as a percentage of shortening.

Results:
In comparison of measurements from the late ultrasound scans with original size the shortening of the Prolift was 45% vs. 25% in Mesh group. When we compared the late and early ultrasound scans, there was no difference in the shrinking of the mesh in both group 16% vs 20%

Conclusion:
Insufficient spreading and anchoring of the anterior Prolift has a major impact on the final length of the mesh. The tissue reaction expressed as shrinking of the mesh is only 16-20%.

Key words:
vaginal mesh, Gynemesh, mesh retraction, mesh shrinking, anterior vaginal repair, pelvic floor ultrasound.


Sources

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2. Deffieux, X., de Tayrac, R., Huel, C., et al. Vaginal mesh erosion after transvaginal repair of cystocele using Gynemesh or Gynemesh-Soft in 138 women: a comparative study. Int Urogynecol J Pelvic Floor Dysfunct 2007, 18, p. 73-79.

3. Konstantinovic, ML., Pille, E., Malinowska, M., et al. Tensile strength and host response towards different polypropylene implant materials used for augmentation of fascial repair in a rat model. Int Urogynecol J Pelvic Floor Dysfunct 2007, 18, p. 619-626.

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5. Klinge, U., Klosterhalfen, B., Muller, M., et al. Shrinking of polypropylene mesh in vivo: an experimental study in dogs. Eur J Surg 1998, 164, p. 965-969.

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7. Shek, KL., Dietz, HP., Rane A., Balakrishnan, S. Transobturator mesh for cystocele repair: a short- to medium-term follow-up using 3D/4D ultrasound. Ultrasound Obstet Gynecol 2008, 32, p. 82-86.

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Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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Czech Gynaecology

Issue 2

2010 Issue 2

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