The multifilament polypropylene tape erosion trouble: tape structure vs surgical technique. Which one is the cause?

Abstract

This study was designed to clarify whether the structure of multifilament tape or the surgical technique is associated with vaginal erosions. Patients were randomized into two groups: in group 1, formed from the patients who were operated with the technique "setting the tape loosely leaving a scissor tip gap between the tape and the urethra," and in group 2, formed from the patients who were operated with the technique "setting the tape actually touched the urethra and covering the tape by the adjacent pubocervicovaginal fascia with the aid of a suture." After 4-year follow-up, it was found that the erosion rate was very high in group 1 (13.6%). We conclude that the high erosion rate seen in multifilament tapes is associated with the surgical technique that is used, not the structure of the multifilament tape.

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

“…The IVS posterior showed good results but carries the risk of mesh erosion. Perhaps a monofilament polypropylene mesh, which was shown to be superior to the multifilament mesh in urinary incontinence surgery with regard to erosion rates, will reduce the risk of erosion in posterior intravaginal slingplasty [63] although Sivaslioglu et al recently showed that these erosions might be technique related [64].…”

An unusual case of vaginal tape exposure following tension-free vaginal tape

“…Jeffrey R. Dell et al reported a case of vaginal tape exposure following TVT due to twisted tape [5]. In another interesting randomised controlled study from Turkey, authors noted the surgical technique of leaving the tape loose did lead to statistically significant number of exposures in this group of patients [6]. In addition, failure to identify the presence of lateral vaginal perforation intraoperatively is a well-recognised risk factor.…”

“…An interesting case of chronic actinomyces infection which led to persistent tape exposure was reported [6]. Authors recommend that the management of vaginal exposure of TVT should include biopsies of eroded mesh and vaginal tissue around the exposure area for both histological analysis and bacterial samples for aerobic and anaerobic culture.…”

Short-term efficacy and complications of posterior intravaginal slingplasty

“…In addition, the removal of the tape raises a real concern about the risk of recurrent prolapse as the longest follow-up data on the posterior IVS is 2 years [10]. There is a recent study, which suggested that the depth of placement of the anterior IVS mesh may have an impact on the erosion rate [17]. This surgical technique could potentially be explored in future posterior IVS study.…”