Ultrasonographic Assessment with Three-Dimensional Mode of the Urethral Compression Effect following Sling Surgery with and without Mesh Surgery

Background. The aim of this study was to assess anatomical changes in the urethra at rest and during straining following sling surgery with and without transvaginal mesh surgery (TVM) in women with stress urinary incontinence (SUI) with or without pelvic organ prolapse (POP) using three-dimensional ultrasonography. Methods. 76 women with SUI with or without pelvic organ prolapse after sling surgery. They underwent sling surgery alone (S group, n=36) or concomitant TVM (M group, n=40). All patients underwent urinalysis, pelvic examinations, urodynamic study, 3D perineal ultrasonography, and personal interviews before and 1 year after surgery. The urethral area was calculated from the axial plane of perineal ultrasonography by multiplying π by the long and short axes of the urethral lumen. Results. The axial area of the middle and distal urethra during straining was significantly smaller than at rest in both groups (P<0.001). In addition, the length of the short axis of the proximal urethra was significantly shorter in those undergoing sling surgery alone during straining compared with those undergoing concomitant sling and mesh surgery (P<0.001). Conclusions. There was a greater impact on the proximal urethra in women who underwent sling surgery alone than those who underwent sling and TVM surgery together.

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Comparison between Preoperative and Postoperative Sexual Function of the Japanese Women Who Underwent Transvaginal Minimal Mesh Surgery for the Treatment of Pelvic Organ Prolapse

10.26226/morressier.59b63e3fd462b80292389276 ◽

2017 ◽

Author(s):

Akiko Fujisaki

Keyword(s):

Pelvic Organ Prolapse ◽

Sexual Function ◽

Pelvic Organ ◽

Japanese Women ◽

Mesh Surgery

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Transvaginal Mesh Surgery for Pelvic Organ Prolapse

Female Pelvic Medicine & Reconstructive Surgery ◽

10.1097/spv.0b013e31827de6de ◽

2013 ◽

Vol 19 (2) ◽

pp. 84-89 ◽

Cited By ~ 6

Author(s):

Salil Khandwala

Keyword(s):

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Transvaginal Mesh ◽

Mesh Surgery

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Long-term outcomes of transvaginal mesh surgery for pelvic organ prolapse: a retrospective cohort study

BMC Women s Health ◽

10.1186/s12905-021-01505-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaojuan Wang ◽

Yisong Chen ◽

Changdong Hu ◽

Keqin Hua

Keyword(s):

Pelvic Organ Prolapse ◽

Patient Characteristics ◽

Pelvic Organ ◽

Transvaginal Mesh ◽

Recurrence Rates ◽

Kaplan Meier ◽

Mesh Surgery ◽

Patient Global Impression

Abstract Background The objective of this study was to evaluate the overall outcomes and complications of transvaginal mesh (TVM) placement for the management of pelvic organ prolapse (POP) with different meshes with a greater than 10-years of follow-up. Methods We performed a retrospective review of patients with POP who underwent prolapse repair surgery with placement of transvaginal mesh (Prolift kit or self-cut Gynemesh) between January 2005 and December 2010. Baseline of patient characteristics were collected from the patients’ medical records. During follow-up, the anatomical outcomes were evaluated using the POP Quantification system, and the Patient Global Impression of Improvement (PGI-I) was used to assess the response of a condition to therapy. Overall postoperative satisfaction was assessed by the following question: “What is your overall postoperative satisfaction, on a scale from 0 to 10?”. Relapse-free survival was analyzed using Kaplan–Meier curves. Results In total, 134 patients were included. With a median 12-year (range 10–15) follow-up, 52 patients (38.8%) underwent TVM surgery with Prolift, and Gynemesh was used 82 (61.2%). 91% patients felt that POP symptom improved based on the PGI-I scores, and most satisfied after operation. The recurrence rates of anterior, apical and posterior compartment prolapse were 5.2%, 5.2%, and 2.2%, respectively. No significant differences in POP recurrence, mesh-associated complications and urinary incontinence were noted between TVM surgery with Prolift versus Gynemesh. Conclusions Treatment of POP by TVM surgery exhibited long-term effectiveness with acceptable morbidity. The outcomes of the mesh kit were the same as those for self-cutmesh.

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Long-term observation on postoperative recurrence and complications of transvaginal mesh surgery for pelvic organ prolapse

Gynecologic and Obstetric Investigation ◽

10.1159/000520979 ◽

2021 ◽

Author(s):

Junfang Yang ◽

Kun Zhang ◽

Jinsong Han ◽

Yiting Wang ◽

Ying Yao ◽

...

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Protective Factor ◽

Pelvic Organ ◽

Vaginal Mesh ◽

Transvaginal Mesh ◽

Mesh Exposure ◽

Mesh Surgery ◽

Post Menopause

Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design：This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data. Conclusion: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however，concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

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Predictive factors for persistence of preoperative overactive bladder symptoms after transvaginal mesh surgery in women with pelvic organ prolapse

LUTS Lower Urinary Tract Symptoms ◽

10.1111/luts.12299 ◽

2019 ◽

Vol 12 (2) ◽

pp. 167-172

Author(s):

Atsushi Otsuka ◽

Kyohei Watanabe ◽

Yuto Matsushita ◽

Hiromitsu Watanabe ◽

Keita Tamura ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Overactive Bladder ◽

Predictive Factors ◽

Pelvic Organ ◽

Transvaginal Mesh ◽

Overactive Bladder Symptoms ◽

Mesh Surgery ◽

Bladder Symptoms

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Evaluation of a Balloon-Type Vaginal Endoscope Based on Three-Dimensional Printing Technology for Self-Assessment of Pelvic Organ Prolapse

Applied Sciences ◽

10.3390/app10155108 ◽

2020 ◽

Vol 10 (15) ◽

pp. 5108

Author(s):

Myoungjae Jun ◽

Hieyong Jeong ◽

Masayuki Endo ◽

Michiko Kodama ◽

Yuko Ohno

Keyword(s):

Pelvic Organ Prolapse ◽

Early Stage ◽

Low Cost ◽

Three Dimensional ◽

Evaluation Study ◽

Pelvic Organ ◽

Self Assessment ◽

Overweight Women ◽

Depth Sensors ◽

Feasibility Evaluation

Pelvic organ prolapse (POP) can occur if the support tissues or the pelvic floor muscles are weakened and damaged. There is increased probability for POP occurrence after childbirth, menopause, or in overweight women. Because the natural history and progression of POP is still unknown, the approaches used to prevent it have not been clear. POP is an uncomfortable condition that affects one every three women. However, most people feel uncomfortable to discuss it. Herein, we conducted a feasibility evaluation study for self-assessment approaches with a vaginal endoscope based on three-dimensional (3D) printing. The proposed endoscope has two parts: (a) rubber material used to cover it for its intended insertion, to avoid direct contact with the walls of the vagina, and (b) two types of sensors at the tip for measurements. The condition inside the vagina was observed with a camera and depth sensors based on the regulation of the amount of air. Arbitrary temporary prolapses from the testbed’s generator enabled us to perceive the location of the problem and symptoms that were regarded as the early stage. As discussed, the low-cost design of the 3D-printed-based vaginal endoscope provides a self-check capability and allows continuous observations that help prevent POP.

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