Evaluation of implant-associated complications after mesh-implants setting in pelvic floor reconstruction

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 69-73
Author(s):  
Alfiya G Yashchuk ◽  
Ilnur I Musin ◽  
Raisa A Naftulovich ◽  
Elena M Popova ◽  
Irina B Fatkullina ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Blood Circulation ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Pelvic Floor Muscles ◽  
Reproductive Age ◽  
Doppler Flowmetry ◽  
Mesh Implant

Relevance. According to world data, nowadays prevalence of pelvic floor dysfunction and pelvic organ prolapsed reaches 28%. Most specialists relate pregnancy and delivery to main factors of pelvic prolapse development. Due to lifespan growth frequency of pelvic organ prolapse development increases. According to FDA data annually in the world is made more than 100 000 surgeries with synthetic implants, herewith heavy complications occur in 3.4% and mild complications occur in 14.8% of all cases. About 58% of surgeries are made to women under the age of 60, 13% of patients needs re-intervention during next 5 years. It should be noted that in cases of relapse more than 30% of women need re-intervention. Aim. Evaluate implant-associated complications after mesh-implants setting. Materials and methods. We have made retrospective analysis of mesh-implant use in 458 patients with pelvic organ prolapse in 2018-2018 yy. on the base of Bashkir State Medical University clinic. In order to assess quality of life after mesh-implant setting, we used the following questionnaires: Incontinence Questionnaire Short Form (ICIQ-SF), and also Female Sexual Function Index (FSFI). In order to assess blood microcirculation indices after surgery, we used laser Doppler flowmetry evaluation from anterior vaginal wall. Results. All in all, there were revealed 13 (2.84%) implant-associated complications. In 4 patients ICIQ-SF points were from 3 to 15, which indicates manifestation of urgent urine incontinence signs. According to FSFI questionnaire, sexually active women have 31.5 points. Basic factor, which provokes pelvic floor muscles dysfunction is delivery. Besides, in group of women of reproductive age, pelvic floor muscles dysfunction (PFMD) is associated with the presence of concomitant gynecologic diseases (uterine myoma, endometriosis, ovarian tumors). In the group of women older than 45 years with the presence of somatic pathology - obesity and impaired blood circulation. According to LDF data from anterior vaginal wall women with PFMD have low blood circulation indices, herewith the lowest indices are registered in the group of women older than 45 years.

scholarly journals Changes in muscularis propria of anterior vaginal wall in women with pelvic organ prolapse

2016 ◽  
Vol 60 (1) ◽  
Author(s):  
A. Vetuschi ◽  
A. D'Alfonso ◽  
R. Sferra ◽  
D. Zanelli ◽  
S. Pompili ◽  
...  
Keyword(s):  
Risk Factors ◽  
Smooth Muscle ◽  
Pelvic Organ Prolapse ◽  
Smooth Muscle Cells ◽  
Muscularis Propria ◽  
Muscle Cells ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Collagen Iii

<p>The objective<strong> </strong>of this study was to evaluate the morphological and immunohistochemical alterations of tissue removed from the upper third of anterior vaginal wall in a sample group of the female population presenting homogenous risk factors associated with Pelvic Organ Prolapse (POP). The case study consisted of 14 patients with POP and there were 10 patients in the control group. Patient selection was carried on the basis of specific criteria and all of the patients involved in the study presented one or more of the recognized POP risk factors. Samples were taken from POP patients during vaginal plastic surgery following  colpohysterectomy, and from control patients during closure of the posterior fornix following hysterectomy. Samples were processed for histological and  immunohistochemical analyses for Collagen I and Collagen III, α-Smooth Muscle Actin (α-SMA), Platelet-Derived-Growth-Factor (PDGF), matrix metalloproteinase 3 (MMP3), Caspase3. Immunofluorescence analyses for Collagen I and III and PDGF were also carried out. In prolapsed specimens our results show a disorganization of smooth muscle cells that appeared to have been displaced by an increased collagen III deposition resulting in rearrangement of the muscularis propria architecture. These findings suggest that the increase in the expression of collagen fibers in muscularis could probably due to a phenotypic switch resulting in the dedifferentiation of smooth muscle cells into myofibroblasts. These alterations could be responsible for the compromising of the dynamic functionality of the pelvic floor.</p><p><strong> </strong></p>

Morphometric analysis of smooth muscle in the anterior vaginal wall of women with pelvic organ prolapse

2002 ◽  
Vol 187 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Muriel K. Boreham ◽  
Clifford Y. Wai ◽  
Rodney T. Miller ◽  
Joseph I. Schaffer ◽  
R.Ann Word
Keyword(s):  
Smooth Muscle ◽  
Pelvic Organ Prolapse ◽  
Morphometric Analysis ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall

Comparative histological analysis of anterior vaginal wall in women with pelvic organ prolapse or control subjects. A pilot study

2008 ◽  
Vol 19 (5) ◽  
pp. 723-729 ◽  
Author(s):  
Wassim Badiou ◽  
Guillaume Granier ◽  
Philippe-Jean Bousquet ◽  
Xavier Monrozies ◽  
Pierre Mares ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pilot Study ◽  
Histological Analysis ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Control Subjects

Repair of cystocele and apical genital prolapse using 6-strap mesh implant

2019 ◽  
Vol 87 (3) ◽  
pp. 130-136
Author(s):  
Mikhail Elikovich Enikeev ◽  
Dmitry Victorovich Enikeev ◽  
Dmitry Olegovich Korolev ◽  
Olesya Vyacheslavovna Snurnitsyna ◽  
Mikhail Vladimirovich Lobanov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Stage Iii ◽  
Pelvic Organ Prolapse Quantification ◽  
Genitourinary Prolapse ◽  
Mesh Implant

Objective: To assess the outcomes of surgical repair of anterior apical prolapse using the 6-strap mesh implant. Study Design: The prospective study included 100 patients with genitourinary prolapse. We used advanced 6-strap mesh implant. The results were assessed at 1 (n = 100) and 12 (n = 93) months after surgery. Maximum follow-up was over 4 years. The anatomical outcomes according to the Pelvic Organ Prolapse Quantification system and intraoperative and postoperative complications were assessed. Stage II and higher prolapse was considered to be a recurrence. The quality of life and sexual function were assessed using Pelvic Organ Prolapse Distress Inventory 20, Pelvic Floor Impact Questionnaire 7, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire 12. Results: Median age was 57 years (34–78 years (95% confidence interval)). All patients had stage III cystocele. The anterior vaginal wall descent in all the patients was associated with uterine descent: 37 (37%), stage II; 60 (60%), stage III; in 3 (3%), stage IV. In eight cases, postoperative de novo stress urinary incontinence developed. The quality of life improved in 93 (93%) women as judged by the Pelvic Floor Distress Inventory 20 data and in 87 (87%) women, according to the Pelvic Floor Impact Questionnaire 7 data. The desirable anatomical result (⩽stage I according to the Pelvic Organ Prolapse Quantification system) was achieved in 97 (97%) patients. With the exception of mesh fragment excision due to erosion (grade 3a), all the complications were classified as grade I according to the Clavien–Dindo classification. Conclusion: Genitourinary prolapse repair using 6-strap mesh is efficacious and relatively safe. The method demonstrates good anatomical results in relation to both anterior and apical prolapses with relatively short-term complications.

scholarly journals Neurovascular alterations of muscularis propria in the human anterior vaginal wall in pelvic organ prolapse

2019 ◽  
Vol 235 (2) ◽  
pp. 281-288 ◽  
Author(s):  
R Sferra ◽  
S Pompili ◽  
A D'Alfonso ◽  
G Sabetta ◽  
E Gaudio ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Muscularis Propria ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall

scholarly journals Recurrent Anterior Vaginal Wall Hernia after a Radical Cystectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-2
Author(s):  
Omar Felipe Dueñas-Garcia ◽  
Kristan Hornsby
Keyword(s):  
Surgical Treatment ◽  
Pelvic Floor ◽  
Radical Cystectomy ◽  
Tissue Repair ◽  
Pelvic Exenteration ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Pelvic Surgery ◽  
Native Tissue Repair ◽  
Mesh Implant

True pelvic floor areas are uncommon conditions, but they can occur after extensive pelvic surgery including radical cystectomies or pelvic exenteration. We present the case of a patient with a persistent hernia that failed a native tissue repair and required a prosthetic mesh implant as definitive surgical treatment.

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