Current state of transvaginal meshes by resolution of pelvic organ prolapse


Authors: J. Jírová;  M. Pán
Authors‘ workplace: Porodnicko-gynekologické oddělení Oblastní nemocnice, Mladá Boleslav, primář MUDr. M. Pán
Published in: Ceska Gynekol 2017; 82(1): 72-78

Overview

Objective:
Treatment of pelvic organs prolapse with transvaginal mesh kits represents nowadays a widespread surgical method, which partially replaced classic operations due to high success rate and low count of recurrences. Just like any other surgical method, the placement of transvaginal mesh is linked with occurrence of complications. In this article we attempt to review the more and less known facts about trans­vaginal meshes, their efficacy, count of recurrence and the spectrum of complications and we try to compare this technique with traditional surgical methods used to treat pelvic organs prolapse (without graft materials).

Design:
Review.

Setting:
Department of Obstetrics and Gynecology, Regional hospital Mladá Boleslav a.s., Mladá Boleslav.

Methods:
Overview of the results of recent studies published in the Czech and English language in recent years.

Results:
Pelvic organ prolapse repair with vaginal mesh has generally lower count of relapse especially in patients with wide genital hiatal area and with major levator ani avulsion. The spectrum of complications differs from classical techniques because of the presence of synthetic nonabsorbable material. Some of the specific complications we did not encounter during classical operations include vaginal mesh erosion, infection of mesh associated with chronic pelvic pain, dyspareunia, protrusion of the mesh into the closest organs or the rejection and progressive extrusion of the mesh.

Conclusion:
Primary enthusiasm has now been replaced with worries of major complications. Future tasks should therefore be aimed at minimizing the rate of complications associated with transvaginal meshes. Except using well-known and safe materials and providing specialized training of physicians for each mesh implantation technique, other precautions outlined in this article should help, such as a closer specification of indication for the application of transvaginal mesh.

Keywords:
transvaginal mesh, efficacy, recurrence, complications, risk factors


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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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