Transobturator mesh for cystocele repair: a short‐ to medium‐term follow‐up using 3D/4D ultrasound

Shek, Ka Lai; Dietz, Hans Peter; Rane, Ajay; Balakrishnan, Sivakumar

doi:10.1002/uog.5361

Cited by 45 publications

(21 citation statements)

References 10 publications

(10 reference statements)

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“…We do not yet know if these modifications improve anatomical outcome. However, Shek et al 12 performed postoperative threedimensional (3D)-4D translabial ultrasonography in 46 patients with cystocele who underwent a transobturator mesh procedure with suture of the mesh to the bladder base. They observed, at a mean follow-up of 10 months, recurrence in six patients (13%), including in five cases cystocele recurrence craniodorsal to the mesh associated with a marked change in orientation of the mesh axis on Valsalva, implying dislodgement of the superior anchoring arms.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound is already used as an informative and objective complementary tool in the evaluation of urinary incontinence and POP 9 . Moreover, polypropylene vaginal meshes as well as polypropylene suburethral slings are hyperechogenic 10 , and different authors have reported the feasibility of analyzing them by standardized two-dimensional (2D) ultrasonography 11,12 . We conducted this study to investigate whether 2D postoperative ultrasonography of polypropylene meshes coupled with a careful clinical examination could help to improve the assessment of mesh retraction and to understand the mechanism of recurrence observed after TVM repair of anterior and/or posterior vaginal wall prolapse.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transvaginal mesh repair of anterior and posterior vaginal wall prolapse: a clinical and ultrasonographic study

Vélémir

Amblard

Fatton

et al. 2010

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transvaginal mesh repair of anterior and posterior vaginal wall prolapse: a clinical and ultrasonographic study

Vélémir

Amblard

Fatton

et al. 2010

Ultrasound in Obstet & Gyne

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“…The levator ani is visible as a multilayer hyperechoic sling at this level. 10 The most caudal portion of the scan reveals the superficial perineal muscles, the perineal body and lower anal canal (Figure 11). Alignment of the pelvic organs (bladder neck or urethra, vagina and rectum or anal canal) indicates that the levator plate is intact, and the arched symmetrical appearance pubic bone is a useful landmark to check that scan has been performed in a neutral position.…”

Section: Three-dimensional Cross-sectional Viewmentioning

confidence: 99%

Total pelvic floor ultrasound for pelvic floor defaecatory dysfunction: a pictorial review

Hainsworth¹,

Solanki²,

Schizas³

et al. 2015

BJR

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Total pelvic floor ultrasound is used for the dynamic assessment of pelvic floor dysfunction and allows multicompartmental anatomical and functional assessment. Pelvic floor dysfunction includes defaecatory, urinary and sexual dysfunction, pelvic organ prolapse and pain. It is common, increasingly recognized and associated with increasing age and multiparity. Other options for assessment include defaecation proctography and defaecation MRI. Total pelvic floor ultrasound is a cheap, safe, imaging tool, which may be performed as a first-line investigation in outpatients. It allows dynamic assessment of the entire pelvic floor, essential for treatment planning for females who often have multiple diagnoses where treatment should address all aspects of dysfunction to yield optimal results. Transvaginal scanning using a rotating single crystal probe provides sagittal views of bladder neck support anteriorly. Posterior transvaginal ultrasound may reveal rectocoele, enterocoele or intussusception whilst bearing down. The vaginal probe is also used to acquire a 360°cross-sectional image to allow anatomical visualization of the pelvic floor and provides information regarding levator plate integrity and pelvic organ alignment. Dynamic transperineal ultrasound using a conventional curved array probe provides a global view of the anterior, middle and posterior compartments and may show cystocoele, enterocoele, sigmoidocoele or rectocoele. This pictorial review provides an atlas of normal and pathological images required for global pelvic floor assessment in females presenting with defaecatory dysfunction. Total pelvic floor ultrasound may be used with complementary endoanal ultrasound to assess the sphincter complex, but this is beyond the scope of this review.

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“…To assess surgical outcome and postoperative complications, the patients' subjective rating is combined with clinical examination and ultrasound imaging. Current imaging modalities reach their limits, however, when they are used to evaluate the mesh arms and their fixation point, especially when trying to verify a correct location or diagnosing misplacement [8]. …”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance-Visible Polypropylene Mesh for Pelvic Organ Prolapse Repair

Brocker¹,

Lippus

Alt

et al. 2014

Gynecol Obstet Invest

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Aim: To develop a magnetic resonance (MR)-visible mesh using iron oxides and prove visibility. Methods: In a phantom study, a suitable iron oxide, Fe₃O₄ [iron(II,III) oxide] and FeOOH [iron(III) oxide-hydroxide], concentration was determined using relaxometric MR measurements of the transverse relaxation rates R2 and R2*. Next, a nonabsorbable mesh was designed from the MR-visible threads woven into a polypropylene mesh. The mesh was implanted into a fresh female cadaver via the transobturator route, and MR visibility was assessed with various MR pulse sequences in a clinical 3-tesla system. Results: Optimal contrast was achieved with Fe₃O₄ at 0.2 weight-% in all imaging sequences, and the optimal contrast was achieved in a 3D spoiled gradient-echo (fast low-angle shot) acquisition. In this concentration range the apparent transverse relaxation rate R2* is below 10 ms. The mesh was visible in the cadaver on T1-weighted 3D spoiled gradient-echo images and T1-weighted fast spin-echo images. Conclusion: Mesh materials can be manufactured to be visible on MR with a negative contrast. Fe₃O₄ meshes could simplify follow-up examinations and help diagnose origins of postsurgical lesions after urogynecological procedures with mesh material.

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Transobturator mesh for cystocele repair: a short‐ to medium‐term follow‐up using 3D/4D ultrasound

Abstract: 21 (range, SD, 7.0) mm in length.Conclusions At 10-month follow-up the Perigee procedure seems to be safe and effective for cystocele repair, with a satisfaction rate of 78%. In some women recurrence may occur due to dislodgment of the superior anchoring arms.

Cited by 45 publications

References 10 publications

Transvaginal mesh repair of anterior and posterior vaginal wall prolapse: a clinical and ultrasonographic study

Transvaginal mesh repair of anterior and posterior vaginal wall prolapse: a clinical and ultrasonographic study

Total pelvic floor ultrasound for pelvic floor defaecatory dysfunction: a pictorial review

Magnetic Resonance-Visible Polypropylene Mesh for Pelvic Organ Prolapse Repair

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