Insertion and Removal of Vaginal Mesh for Pelvic Organ Prolapse

@article{MMuffly2010InsertionAR,
  title={Insertion and Removal of Vaginal Mesh for Pelvic Organ Prolapse},
  author={Tyler M Muffly and Matthew D. Barber},
  journal={Clinical Obstetrics and Gynecology},
  year={2010},
  volume={53},
  pages={99-114}
}
A variety of surgical meshes are available to correct pelvic organ prolapse. This article discusses benefits and risks of vaginal mesh use. Emphasis is placed on the appropriate surgical technique to improve outcomes and minimize mesh complications. Placement options are reviewed with the discussion of self-tailored mesh, trocar-based mesh kits, and non-trocar mesh kits. This article also reviews the management of mesh complications including the technique for mesh removal. 
Management of Complications Related to Mesh Use Within the Female Pelvis
TLDR
It is imperative to have a good understanding of the mesh available on the market, appropriate use in patients, and the serious risks of complications, as use of pelvic organ prolapse surgery with mesh is increasing.
Vaginal Mesh in Pelvic Reconstructive Surgery: Controversies, Current Use, and Complications
TLDR
Recommendations now exist not only on the placement of mesh and patient selection, but also on the evaluation and management of mesh-related complications, which have been supported by several gynecologic societies.
An Update on the Use of Mesh in Pelvic Reconstructive Surgery
  • C. Unger
  • Medicine
    Current Obstetrics and Gynecology Reports
  • 2016
TLDR
Transvaginal mesh use has declined substantially since FDA sanctions were placed, and its use should remain in the hands of experienced pelvic floor surgeons in patients who meet strict criteria and are well informed about its potential risks and benefits.
Surgical Techniques for Removing Problematic Mesh
  • M. Barber
  • Medicine
    Clinical obstetrics and gynecology
  • 2013
TLDR
The use of mesh and graft in pelvic reconstructive surgery has increased over the last decade, however a notable portion of patients will require more than 1 operation and complete symptom resolution is not always achieved.
Managing Complications of Implanted Mesh
TLDR
The history of surgical mesh and how it arrived at its current inflection point are discussed, and standardized terminologies for describing mesh-related complications are reviewed.
Pelvic Organ Prolapse: Anterior Compartment—Kits and Customised Repairs
TLDR
Primary surgery can itself prove problematic because the majority of cystoceles are treated with ‘standard’ midline fascial plication repairs in contrast to the anatomical defects which can be diverse in location.
Mesh colposacropexy in the management of anterior vaginal compartment prolapse
TLDR
The transvaginal polypropylene mesh approach can prove itself to be a viable solution for the management of genital prolapse, especially if the authors consider the high postoperative rates of anatomical success and low rates of postoperative complications, as well as improving the patient’s quality of life.
Mesh in Prolapse Surgery
TLDR
To fully understand the dynamics of prolapse surgery, both native tissue and mesh repair, it is important to have a brief overview of the functional anatomy of the pelvic floor.
Surgical Management of Female Voiding Dysfunction.
Transvaginal Prolapse Repair
TLDR
The transvaginal approach to pelvic floor reconstruction offers the potential benefits of decreased morbidity, convalescence, and cost compared to the transabdominal approach, however, long-term outcomes can vary and an informed discussion with the patient and consideration of surgeon expertise should guide the approach used for pelvicfloor reconstruction.
...
1
2
3
...

References

SHOWING 1-10 OF 22 REFERENCES
Surgical management of pelvic organ prolapse in women: A short version Cochrane review
Pelvic organ prolapse may occur in up to 50% of parous women. A variety of urinary, bowel and sexual symptoms may be associated with prolapse.
[Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh].
Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits.
Surgical management of pelvic organ prolapse in women.
TLDR
Meta-analysis on the impact of continence surgery at the time of prolapse surgery was performed with data from seven studies, and abdominal sacral colpopexy was associated with a lower rate of recurrent vault prolapse and dyspareunia than with vaginal sacrospinous col popexy.
Low-Weight Polypropylene Mesh for Anterior Vaginal Wall Prolapse: A Randomized Controlled Trial
TLDR
Anterior colporrhaphy, reinforced with, tailored mesh significantly reduced the rate of recurrence of anterior vaginal wall prolapse compared with the traditional operation, but was associated more often with stress urinary incontinence.
Surgical management of pelvic organ prolapse in women.
TLDR
Abdominal sacrocol popexy is associated with a lower rate of recurrent vault prolapse and dyspareunia than the vaginal sacrospinous colpopexy and Posterior vaginal wall repair may be better than transanal repair in the management of rectoceles in terms of recurrence of prolapse.
Sexual Dysfunction After Trocar-Guided Transvaginal Mesh Repair of Pelvic Organ Prolapse
TLDR
Sexual function scores deteriorate 1 year after trocar-guided transvaginal mesh surgery, and the worsening was attributed primarily to a worsening in behavioral–emotive and partner-related items.
Retrospective multicentre study of the new minimally invasive mesh repair devices for pelvic organ prolapse
TLDR
Without comparative data of their results prior to adopting these new techniques, it is difficult to understand the rationale for such a dramatic uptake of synthetic mesh for pelvic floor reconstruction and how their management has benefited by the new techniques.
Clinical Practice Guidelines on Vaginal Graft Use From the Society of Gynecologic Surgeons
  • M. Murphy
  • Medicine
    Obstetrics and gynecology
  • 2008
TLDR
It is suggested that native tissue repair remains appropriate when compared with biologic graft use, and nonabsorbable synthetic graft use may improve anatomic outcomes of anterior vaginal wall repair, but there are trade-offs in regard to additional risks.
Complication and Reoperation Rates After Apical Vaginal Prolapse Surgical Repair: A Systematic Review
TLDR
The rate of complications requiring reoperation and the total reoperation rate was highest for vaginal mesh kits despite a lower re operation rate for prolapse recurrence and shorter overall follow-up.
...
1
2
3
...