Imaging of slings and meshes

Abstract

The popularity of imaging in pelvic floor medicine continues to increase. Among the various modalities, ultrasound is superior as it is cheap, safe, easily accesible and simple, resulting in high patient compliance. It is the only technique that allows imaging of modern wide‐weave polypropylene sling or mesh implants, and imaging of such implants is commonly required due to the popularity of surgical techniques that involve the placement of slings and meshes. This review article will discuss the role of translabial ultrasound in the evaluation of synthetic implants used in the treatment of urinary incontinence and pelvic organ prolapse.

3D reconstruction of MR‐visible Fe3O4‐mesh implants: Pelvic mesh measurement techniques and preliminary findings

“…We are not advocating that all women have preoperative and postoperative MRIs, but the mesh MR‐visibility allows us to quantify and understand its placement in a research setting or as a diagnostic tool when complications arise. We recognize that ultrasound as the imaging tool of choice in most clinical situations is very effective in visualizing mesh material between the anterior vaginal wall and the bladder, helping diagnose mesh folding or dislodgement, and in recurrent prolapse situations . But when trying to evaluate the mesh arms passing through the deep pelvic structures and body wall, this MR‐visible mesh‐based technique illuminates areas of the postoperative pelvic “situs” that were hidden until now.…”

“…We recognize that ultrasound as the imaging tool of choice in most clinical situations is very effective in visualizing mesh material between the anterior vaginal wall and the bladder, helping diagnose mesh folding or dislodgement, and in recurrent prolapse situations. 10,11,23,24 But when trying to evaluate the mesh arms passing through the deep pelvic structures and body wall, this MR-visible mesh-based technique illuminates areas of the postoperative pelvic “situs” that were hidden until now. By simultaneously capturing the entire pelvis and mesh, this technique can provide additional information in some complex circumstances, such as postoperative pelvic pain or recurrent prolapse.…”

An Unusual Case of Acute Complete Urinary Incontinence 20 Days after Pelvic Floor Surgery and Tension-Free Vaginal Tape Insertion 20 Days after Pelvic Floor Surgery and Tension-Free Vaginal Tape Insertion

“…The hematoma and the tension free vaginal tape were clearly seen by transperineal and translabial ultrasound. Sonography allows dynamic imaging and the sling implants are highly echogenic [9]. In MR scan they are not clearly visible, except for MR-visible Fe 3 O 4 -mesh implants [10].…”

Association between 3D endovaginal and 2D perineal pelvic floor ultrasound findings and symptoms in women presenting with mid‐urethral sling complications

“…6 Research to date has mostly utilised 3-and 4-dimensional (3/4D) perineal or translabial modalities. [8][9][10][11] Perineal pelvic floor ultrasound (pPFUS) allows dynamic assessment of mid-urethral slings (MUS); performed with a curvilinear probe, widely available in most gynaecology departments. Although 3D endovaginal ultrasound (EVUS) requires specialist equipment, it offers reliable, high frequency imaging of the whole pelvic floor.…”