Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene/polyglactin 910 (Vypro II) mesh

Achtari, Chahin; Hiscock, Richard; O’Reilly, Barry; Schierlitz, Lore; Dwyer, Peter

doi:10.1007/s00192-004-1272-3

Cited by 140 publications

(90 citation statements)

References 19 publications

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“…Several explanations for the different prevalence rates of IVS mesh erosion were given. Atachi et al report that women operated on by less-experienced surgeons had more erosion problems than women who were operated on by more experienced surgeons [57]. Hefni et al did not confirm these findings but reported that older age (>60 years) and diabetes mellitus were associated with a higher rate of mesh erosions [39].…”

Section: Surgical Proceduresmentioning

confidence: 98%

Vaginal surgery for uterine descent; which options do we have? A review of the literature

2008

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Several vaginal procedures are available for treating uterine descent. Vaginal hysterectomy is usually the surgeon's first choice. In this literature review, complications, anatomical and symptomatic outcomes, and quality of life after vaginal hysterectomy, sacrospinous hysteropexy, the Manchester procedure, and posterior intravaginal slingplasty are described. All procedures had low complication rates, except posterior intravaginal slingplasty, with a tape erosion rate of 0-21%. Minimal anatomical success rates regarding apical support ranged from 85% and 93% in favor of the Manchester procedure. Data on symptomatic cure and quality of life are scarce. In studies comparing vaginal hysterectomy with sacrospinous hysteropexy or the Manchester procedure, vaginal hysterectomy had higher morbidity. Because no randomized, controlled trials have been performed comparing these surgical techniques, we can not conclude that one of the procedures prevails. However, one can conclude from the literature that vaginal hysterectomy is not the logical first choice.

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Section: Surgical Proceduresmentioning

confidence: 98%

Vaginal surgery for uterine descent; which options do we have? A review of the literature

2008

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“…The current knowledge on in vivo characteristics of permanent mesh and their associated outcomes in urogynecologic surgery is mainly derived from retrospective studies [4][5][6] and small prospective case series [7][8][9]. Because of its beneficial profile in experimental settings [10,11], favorable pilot studies [12,13], as well as proven efficacy and tissue-friendly qualities when used in stress urinary incontinence surgery [14], most synthetic biomaterials currently marketed are monofilament, macroporous polypropylene mesh.…”

Section: Introductionmentioning

confidence: 99%

Short-term outcome after transvaginal mesh repair of pelvic organ prolapse

et al. 2007

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The objective of this study is to report on shortterm outcomes after pelvic organ prolapse repair using Prolift transvaginal mesh. A 3-year multicenter prospective cohort study was performed in 28 centers. Assessment preoperatively and at 2 months postoperatively included the condition-specific pelvic organ prolapse quantification system (POP-Q) and a macroscopic inflammatory scale. Subjective outcome was measured using the urogenital distress inventory (UDI) and the incontinence impact questionnaire (IIQ-7). Surgical characteristics and adverse events during follow-up were registered in a separate protocol. The evaluation is based on the interim safety analysis and includes 2-month evaluations of 123 cases. Pelvic organ perforation occurred in four cases (3.2%), three bladder injuries and one case of rectal perforation. At the 2-month follow-up, there were two cases of mesh exposure, an increase of mild-moderate granuloma formation in the operated areas (P < 0.003) but no cases of serious adverse tissue reactions related to the polypropylene mesh. Postoperative anatomical cure (defined as POP-Q stage 0-1) was 87% after anterior repair, 91% after posterior repair and 88% after total repair. All quality of life aspects measured by the IIQ-7 improved 2 months after surgery. Pelvic heaviness, vaginal bulging, and vaginal protrusion all decreased considerably (P < 0.001). There was also a significant improvement in several lower urinary tract symptoms and a decreased need for manually assisted defecation. This first report from an ongoing multicenter study suggests that transvaginal mesh surgery with the Prolift system is associated with satisfactory outcomes 2 months after surgery. There were no severe adverse events attributed to the polypropylene mesh.

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“…The authors explained that this difference was most likely due to vessel injury associated with uterine cervix dissection. Some studies have reported that patient age is another independent risk factor for the development of an erosion [18,20]. Deffieux et al [18] compared the erosion rate between the use of Gynemesh TM PS and the use of Gynemesh-Soft, which is designed to be more supple and flexible.…”

Section: Discussionmentioning

confidence: 99%

“…Another study found no significant difference in the incidence of vaginal erosions between the use of Atrium (a polypropylene nonabsorbable, monofilament, macroporous mesh) and the use of Vypro II (a composite polypropylene/polyglactin 910, mono/multifilament, absorbable/nonabsorbable mesh). Vypro II is designed to weigh less than Atrium and also induces less of an inflammatory response [20] than do Mersilene and Marlex mesh [21].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of "Tension-free" Placement of Gynemesh PS for the Treatment of Anterior Vaginal Wall Prolapse

et al. 2010

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Purpose: To evaluate the efficacy and safety of the tension-free placement of a monofilament polypropylene mesh for the repair of an anterior vaginal wall prolapse (AVWP). Materials and Methods: Women aged ≥ 30 years with an AVWP stage of II or greater were included. Forty-nine women underwent trans-vaginal repair using a Gynemesh TM PS. Forty-six women who had symptomatic stress urinary incontinence received a midurethral sling (MUS). At the 12-month follow-up, evaluations were made for changes in the Pelvic Organ Prolapse Quantification (POP-Q) stage and Pelvic Floor Distress Inventory. Cure was defined as a POP-Q stage of 0 and improvement as a stage of I. Complications were also evaluated. Results: The cure rate was 71.4%, and the improvement rate was 18.4%. Obstructive/discomfort, irritative, and stress subscale scores of the Urinary Distress Inventory anterior and posterior subscale scores of the POP Distress Inventory and the obstructive subscale score of the Colo-Rectal-Anal Distress Inventory were significantly improved. Thirty-two of the 46 women (69.6%) who received MUS procedures reported no leakage after surgery. Complications were 2 cases of increased intraoperative bleeding and 1 case of vaginal erosion. Conclusions: Trans-vaginal repair using a Gynemesh TM PS is a feasible and effective procedure for the treatment of AVWP with no significant complications.

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Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene/polyglactin 910 (Vypro II) mesh

Cited by 140 publications

References 19 publications

Vaginal surgery for uterine descent; which options do we have? A review of the literature

Vaginal surgery for uterine descent; which options do we have? A review of the literature

Short-term outcome after transvaginal mesh repair of pelvic organ prolapse

Efficacy and Safety of "Tension-free" Placement of Gynemesh PS for the Treatment of Anterior Vaginal Wall Prolapse

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