An innovative approach to treating vaginal mesh exposure after abdominal sacral colpopexy: endoscopic resection of mesh and platelet-rich plasma; initial experience in three women

Castellani, Daniele; Valloni, Alessandra; Piccirilli, A.; Galatioto, Giuseppe Paradiso; Vicentini, Carlo

doi:10.1007/s00192-016-3154-x

Cited by 8 publications

(8 citation statements)

References 7 publications

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“…26 Castellani et al presented their initial experience in 3 symptomatic women with vaginal mesh exposure following abdominal sacrocolpopexy, who were treated with endoscopic mesh excision with resectoscope followed by application of PRP on the resected surface and of PRP-gel injection around it at the same surgery. 27 A complete re-epithelization was recorded 6 months postoperatively and relief of preoperative symptoms and no prolapse were noted at 1-year follow-up. 27 Furthermore, based on the outcomes of animal experimental studies, coating of polypropylene meshes with PRP seems promising in preventing exposure and enhancing recovery.…”

Section: Resultsmentioning

confidence: 94%

“…27 A complete re-epithelization was recorded 6 months postoperatively and relief of preoperative symptoms and no prolapse were noted at 1-year follow-up. 27 Furthermore, based on the outcomes of animal experimental studies, coating of polypropylene meshes with PRP seems promising in preventing exposure and enhancing recovery. More specifically, Parizzi et al reported a decreased inflammatory infiltration at 30 days and increased collagen III concentration at 90 days in the histologic specimen of PRP-coated meshes which were implanted in the vaginal mucosa of 15 rabbits.…”

Section: Resultsmentioning

confidence: 94%

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The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders

et al. 2021

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Background: The regenerative efficacy of platelet-derived products has been recently investigated in the treatment of pelvic floor disorders (PFDs). We aimed to synthesize the current evidence of platelet-rich plasma (PRP) products used in urogynaecological disorders including vaginal atrophy, pelvic organ prolapse (POP), urinary incontinence, vaginal fistulas and vaginal mesh exposure. Methods: A meticulous search of the currently available literature on the use of PRP for the management of PFDs was performed using 3 electronic databases. Results: PRP could be a feasible alternative modality for the management of vaginal atrophy with favourable outcomes in vaginal atrophy parameters and patients’ satisfaction, especially when hormone therapy is contraindicated. In patients with POP, an increase in collagen concentration after PRP application was observed while the use of PRP resulted in improvement of stress urinary incontinence symptoms. A considerable proportion of vesicovaginal fistulas were treated after application of PRP-based injections. Conclusions: There is only limited evidence of the use of PRP for PFDs. Platelet-rich plasma appears to be a promising, easy to apply, cost-effective and feasible alternative therapeutic modality for the management of various urogynaecological disorders. Future randomized trials are needed to confirm the efficacy of PRP in the treatment of urogynaecological disorders.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 94%

The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders

et al. 2021

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“…The Heterogeneity of reporting methods renders drawing conclusions rather problematic, even though the effectiveness of PRP in FSD and female SUI has been demonstrated. Adding to this, data from studies analyzing other female pelvic diseases (e.g., female pelvic organ prolapse, vesicovaginal fistula and vaginal mesh exposure), erectile function and male SUI suggest that PRP injections may improve symptoms [45][46][47][48][49][50].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Platelet-Rich Plasma Injections for the Treatment of Female Sexual Dysfunction and Stress Urinary Incontinence: A Systematic Review

Dankova,

Pyrgidis,

Tishukov

et al. 2023

Biomedicines

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Introduction: There is no clear evidence in the literature that platelet-rich plasma (PRP) injections improve female sexual dysfunction (FSD) and female stress urinary incontinence (SUI). Objectives: A systematic review was performed to study the efficacy and safety of PRP injections in women with the above pathologies, as well as to explore the optimal dosing, frequency and area of injections, and duration of treatment. Methods: A systematic search on PubMed, Embase and the Cochrane Library database was performed, as well as sources of grey literature from the date of database or source creation to January 2023. After title/abstract and full-text screening, clinical studies on humans evaluating the efficacy of PRP in gynecological disorders using standardized tools were included. Risk of bias was undertaken with RoB-2 for randomized-controlled trials (RCT) and the Newcastle-Ottawa Scale (NOS) for observational studies. Results: Four prospective and one retrospective study explored FSD, while six prospective and one RCT evaluated female SUI. A total of 327 women with a mean age of 51 ± 12 years were included. For FSD, PRP significantly improved the Female Sexual Function Index (FSFI), the Vaginal Health Index (VHI) and the Female Sexual Distress score (FSDS). For SUI, PRP led to a significant improvement in the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) and the Urogenital Distress Inventory (UDI-6). The identified RCT reported a significantly higher mean score of ICIQ-SF (p < 0.05) and UDI-6 (p < 0.01) in the midurethral sling group compared to the PRP injections group. Regarding the risk of bias, the RCT was characterized by high risk, whereas the observational studies were of moderate risk. The protocol for PRP injections for FSD is the injection of 2 mL of PRP into the distal anterior vaginal wall once a month for 3 months. For female SUI, 5–6 mL of PRP should be injected into the periurethral area once a month for 3 months. Conclusions: Despite the promising initial results of PRP injections, the level of current evidence is low due to methodological issues in the available studies. It becomes clear that there is an emerging need for high-quality research examining PRP injections for the treatment of FSD and female SUI.

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“…In the field of obstetrics and gynecology, use of PRP has only recently been reported. PRP was shown to accelerate the wound healing after cesarean delivery in high-risk patients in a case control study [33] and helped to close vaginal gap in three cases of vaginal mesh exposure, when applied after the mesh resection [34]. Platelets contain alpha-granules that store large numbers of growth factors and cytokines involved in cell proliferation, migration, differentiation, and angiogenesis and are released upon platelet activation at the site of injury or inflammation [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich plasma in the management of Asherman syndrome: case report

Aghajanova

Cedars

Huddleston

2018

J Assist Reprod Genet

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An innovative approach to treating vaginal mesh exposure after abdominal sacral colpopexy: endoscopic resection of mesh and platelet-rich plasma; initial experience in three women

Abstract: Our preliminary results show that BPR and PRP are safe, effective, and feasible for treating vaginal mesh exposure with conservation of anatomy and sexual function.

Cited by 8 publications

References 7 publications

The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders

The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders

Efficacy and Safety of Platelet-Rich Plasma Injections for the Treatment of Female Sexual Dysfunction and Stress Urinary Incontinence: A Systematic Review

Platelet-rich plasma in the management of Asherman syndrome: case report

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