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Transvaginal Mesh Repair for Pelvic Organ Prolapse: Toward a New Era

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Book cover Management of Pelvic Organ Prolapse

Abstract

Surgical treatment of pelvic organ prolapse (POP) is very common in the female gender and is gradually increasing. Many women are living longer and have a high expectation for quality of life beyond menopause including an active lifestyle and the capacity for sexual activity. An increasing number of mesh kits were introduced on the trade, pushed by industry, reaching in 2010 almost 100 devices on the market. The proposed advantages of meshes are the reduced surgical trauma, the standardization of techniques, a faster learning curve and the use and ability to repair multiple compartments POP through a vaginal approach. This dramatic increase of mesh systems has led to a parallel increase of surgical complications. Current use of mesh in transvaginal POP surgery is perfectible, and in order to reduce adverse effects and complications, research for the ideal mesh material is ongoing. It is critical to highlight that surgeons and Institutions treating POP should offer both transvaginal and transabdominal (especially minimally-invasive) approaches in order to offer patients a personalized approach that is tailored to the POP’s and patient’s characteristics.

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References

  1. Olsen AL, Smith VJ, Bergstrom JO, et al. Epidemiology of surgical managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89:501.

    Article  CAS  PubMed  Google Scholar 

  2. Porges RF, Smilen SW. Long term analysis of the surgical management of pelvic support defects. Am J Obstet Gynecol. 1994;171(6):1518–26.

    Article  CAS  PubMed  Google Scholar 

  3. Smith FJ, Holman CD, Moorin RE, et al. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010;116:1096.

    Article  PubMed  Google Scholar 

  4. Witheside JL, Weber AM, Meyn LA, et al. Risk fctors for prolapse recurrence after vaginal repair. Am J Obstet Gyncol. 2004;191:1533–8.

    Article  Google Scholar 

  5. Moore J, Armstrong JT, Willis SH. The use of tantalum mesh in cystocele with critical report of ten cases. Am J Obstet Gynecol. 1955;69(5):1127–35.

    Article  CAS  PubMed  Google Scholar 

  6. Friedman EA, Meltzer RM. Collagen mesh prosthesis for repair of endopelvic fascial defects. Am J Obstet Gynecol. 1970;106(3):430–3.

    Article  CAS  PubMed  Google Scholar 

  7. Zacharin RF. Free full-thickness vaginal epithelium graft in correction of recurrent genital prolapse. Aust N Z J Obstet Gynaecol. 1992;32(2):146–8.

    Article  CAS  PubMed  Google Scholar 

  8. Julian TM. The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol. 1996;175(6):1472–5.

    Article  CAS  PubMed  Google Scholar 

  9. Flood CG, Drutz HP, Waja L. Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(4):200–4.

    Article  CAS  PubMed  Google Scholar 

  10. Nicita G. A new operation for genitourinary prolapse. J Urol. 1998;160(3 Pt 1):741–5.

    Article  CAS  PubMed  Google Scholar 

  11. Mage P. Interposition of a synthetic mesh by vaginal approach in the cure of genital prolapse. J Gynecol Obstet Biol Reprod. 1999;28(8):825–9.

    CAS  Google Scholar 

  12. Migliari R, Usai E. Treatment results using a mixed fiber mesh in patients with grade IV cystocele. J Urol. 1999;161(4):1255–8.

    Article  CAS  PubMed  Google Scholar 

  13. Weber AM, Walters MD, Piedmonte MR, Ballard LA. Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol. 2001;185(6):1299–304; discussion 1304-6.

    Article  CAS  PubMed  Google Scholar 

  14. Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ, Goldberg R. Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol. 2001;184(7):1357–62; discussion 1362-4.

    Article  CAS  PubMed  Google Scholar 

  15. Shah DK, Paul EM, Rastinehad AR, Eisenberg ER, Badlani GH. Short-term outcome analysis of total pelvic reconstruction with mesh: the vaginal approach. J Urol. 2004;171(1):261–3.

    Article  PubMed  Google Scholar 

  16. Lensen EJM, et al. Surgical treatment of pelvic organ prolapse: a historical review with emphasis on the anterior compartment. Int Urogynecol J. 2013;24:1593–602.

    Article  CAS  PubMed  Google Scholar 

  17. Committee on Gynecologic Practice. Committee Opinion no.513: vaginal placement of synthetic mesh for pelvic organ prolapse. Ostet Gynecol. 2011;118(6):1459–64.

    Article  Google Scholar 

  18. Chen CC, Ridgeway B, Paraiso MF. Biologic grafts and synthetic meshes in pelvic reconstructive surgery. Clin Obstet Gynecol. 2007;50(2):383–411.

    Article  PubMed  Google Scholar 

  19. Amid PK. Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia. 1997;1:15–21.

    Article  Google Scholar 

  20. Rogo-Gupta L, Rodriguez LV, Litwin MS, et al. Trends in surgical mesh use for pelvic organ prolapse from 2000 to 2010. Ostet Gynecol. 2012;120(5):1105–15.

    Google Scholar 

  21. Sliva WA, Karram MM. Scientific basis for use of grafts during vaginal reconstructive procedures. Curr Opin Obstet Gynecol. 2005;17(5):519–29.

    Article  Google Scholar 

  22. Roovers J-P. Collaboration with the mesh industry: who needs who. Int Urogynecol J. 2016;27:1293–5. https://doi.org/10.1007/s00192-016-3075-8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Jonsson Funk M, Edenfield AL, Pate V, et al. Trends in use of surgical mesh for pelvic organ prolapse. Am J Obstet Gynecol. 2013;208(1):79–97.

    PubMed  Google Scholar 

  24. FDA safety communication. UPDATE on serious complications associated with transvaginal placement of surgical mesh for pelvic organ prolapse. Silver Spring; FDA July 27, 2011.

    Google Scholar 

  25. FDA Executive Summary Surgical mesh for the treatment of women with pelvic organ prolapse and stress incontinence; Obstetric and Gynecology Devices Advisory Committee Meeting; 2011. Sept 8.

    Google Scholar 

  26. ACOG. Joint recommendations issued on use of vaginal mesh for POP. November 21, 2011.

    Google Scholar 

  27. Costantini E, Lazzeri M. What part does mesh play in urogenital prolapse management? Curr Opin Urol. 2015;25:300–4.

    PubMed  Google Scholar 

  28. SCENIHR Opinion on The safety of surgical meshes used in urogynecologicalsurgery. The SCENIHR approved this Opinion on 3 December 2015.

    Google Scholar 

  29. FDA Strengthens requirement for surgical mesh for the tranvaginal repair of POP to address safety risks- Janury 4, 2016.

    Google Scholar 

  30. Skoczylas LC, Turner LC, Wang L, Winger DG, Shepherd JP. Changes in prolapse surgery trends relative to FDA notifications regarding vaginal mesh. Int Urogynecol J. 2014;25(4):471–7. https://doi.org/10.1007/s00192-013-2231-7.

    Article  PubMed  Google Scholar 

  31. Haya N, Baessler K, Christmann-Schmid C, et al. Prolapse and continence surgery in countries of the organization for economic cooperation and development in 2012. Am J Obstet Gynecol. 2015;212:755.

    Article  PubMed  Google Scholar 

  32. Ghoniem G, Hammett J. Female pelvic medicine and reconstructive surgery practice patterns: IUGA member survey. Int Urogynecol J. 2015;26(10):1489–94. https://doi.org/10.1007/s00192-015-2734-5. Epub 2015 May 28

    Article  PubMed  Google Scholar 

  33. Younger A, Rac G, Clemens JQ, Kobashi K, Nitti V, Jacobs I, Lemack GE, Brown ET, Dmochowski R, Maclachlan L. Pelvic organ prolapse surgery in academic female pelvic medicine and reconstructive surgery urology practice in the setting of the food and drug administration public health notifications. Urology. 2016;91:46–51. https://doi.org/10.1016/j.urology.2015.12.057.

    Article  PubMed  Google Scholar 

  34. Maher C, Feiner B, Baessler K, et al. Transvaginal mesh or grafts compared with native tissue repair for vaginal prolapse (Review). Cochrane Database Syst Rev. 2016;11:CD004014.

    PubMed  Google Scholar 

  35. Nieminen K, Hiltunen R, Takala T, et al. Outcomes after anterior vaginal wall repair with mesh: a randomized controlled trial with 3 year follow-up. Am J Obstet Gynecol. 2010;203(3):235–8.

    Article  PubMed  Google Scholar 

  36. Rudnicki M, Laurikainen E, Pogosean R, et al. A 3-year follow-up after anterior colporraphy compared with collagen coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG. 2016;123(1):136–42.

    Article  CAS  PubMed  Google Scholar 

  37. Meyer I, McGwin G, Swain TA, et al. Synthetic graft augmentation in vaginal prolapse surgery: long-term objective and subjective outcomes. J Minim Invasive Gynecol. 2016;23:616–21.

    Article  Google Scholar 

  38. Lamblin G, Van-Nieuwenhuyse A, Chabert P, et al. A randomized controlled trial comparing anatomical and functional outcome between vaginal colposuspension and transvaginal mesh. Int Urogynecol J. 2014;25:961–70.

    Article  CAS  PubMed  Google Scholar 

  39. Svabik K, Martan A, Masata J, et al. Comparison of vaginal mesh repair with sacrospinous vaginal colpopexy in the management of vaginal vault prolapse after hysterectomy in patients with levator ani avulsion: a randomized controlled trial. Ultrasound Obstet Gynecol. 2014;43:365–71.

    Article  CAS  PubMed  Google Scholar 

  40. Milani AL, Vollebregt A, Roovers JP, Withagen MIJ. The use of mesh in vaginal prolapse. Ned Tijdschr Geneeskd. 2013;157(31):A6324. Review.

    PubMed  Google Scholar 

  41. Fritsch H, Lienemann A, Brenner E, et al. Clinical anatomy of the pelvic floor. Adv Anat Embryol Cell Biol. 2004;175:III–X, 1-64.

    CAS  PubMed  Google Scholar 

  42. Jia X, Glazener C, Mowatt G, Jenkinson D, Fraser C, Bain C, Burr J. Systematic review of the efficacy and safety of using mesh in surgery for uterine or vaginal vault prolapse. Int Urogynecol J. 2010;21(11):1413–31.

    Article  PubMed  Google Scholar 

  43. Diwadkar GB, Barber MD, Feiner B, Maher C, Jelovsek JE. Complication and reoperation rates after apical vaginal prolapse surgical repair: a systematic review. Obstet Gynecol. 2009;113(2 Pt 1):367–73.

    Article  PubMed  Google Scholar 

  44. Ellington DR, Richter HE. Indications, Controindications, and Complications of mesh in surgical Treatment of Peelvic Organ Prolapse. Clin Obstet Gynecol. 2013;56(2):276–88.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Dallenbach P. To mesh or not to mesh: a review of pelvic organ reconstruttive surgery. Int J Womens Health. 2015;7:331–43.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Wang AC, Lee L, Lin CT, et al. A istologic and immunohistochemical analysis of defective vaginal healing after continence taping procedures: a prospective case-controlled pilot study. Am J Obstet Gynecol. 2004;191:1868–74.

    Article  PubMed  Google Scholar 

  47. Barski D, Otto T, Gerullis H. Systematic review and classification of complications after anterior, posterior, apical and total vaginal mesh implantation for prolapse repair. Surg Technol Int. 2014;24:217–24.

    PubMed  Google Scholar 

  48. Achtari C, Hiscock R, O’Reilly BA, et al. Risk factors for mesh erosion after transvaginal surgery using polypropilene or composite polypropilene mesh. Int Uroynecol J Pelvic Floor Dyfunct. 2005;16(5):389–94.

    Article  Google Scholar 

  49. Liang R, Zong W, Palcsey S, et al. Impact of prolapse meshes on the metabolism of vaginal extracellular matrix in rhesus macaque. Am J Obstet Gynecol. 2015;212:174.e1–e17.

    Article  CAS  Google Scholar 

  50. Noblett K, Brueseke T, Lin F, Rosenblatt P. Comparison of location of mesh placed transvaginally vs mesh placed abdominally at the time of sacrocolpopexy. Int Urogynecol J. 2015;26:79–83.

    Article  PubMed  Google Scholar 

  51. Maher C, et al. Pelvic organ prolapse surgery. In: Abrams P, Cardozo L, Wagg A, Wein A, editors. Incontinence: 6th International Consultation on Incontinence. Tokyo 2016; 2017. p. 1855–991.

    Google Scholar 

  52. Leboeuf L, Miles RA, Kim SS, Gousse AE. Grade 4 cystocele repair using 4-defect repair and porcine xenograft acellular matrix (Pelvicol). Outcome measures using SEAPI. Urology. 2004;64(2):282–6.

    Article  PubMed  Google Scholar 

  53. Meschia M, Pifarotti P, Bernasconi F, et al. Porcine skin collagen implants to prevent anterior vaginal wall prolapse recurrence: a multicenter, randomized study. J Urol. 2007;177(1):192–5.

    Article  PubMed  Google Scholar 

  54. Natale F, La Penna C, Padoa A, et al. A prospective, randomized, controlled study comparing Gynemesh, a synthetic mesh, and Pelvicol, a biologic graft, in the surgical treatment of recurrent cystocele. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(1):75–81.

    Article  CAS  PubMed  Google Scholar 

  55. Feldner PC, Castro RA, Cipolotti LA, et al. Anterior vaginal wall prolapse: a randomized controlled trial of SIS graft versus traditional colporrhaphy. Int Urogynecol J Pelvic Floor Dysfunct. 2010;21(9):1057–63.

    Article  Google Scholar 

  56. Menefee SA, Dyer KY, Lukacz ES, et al. Colporrhaphy compared with mesh or graft-reinforced vaginal paravaginal repair for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol. 2011;118:1337–44.

    Article  PubMed  Google Scholar 

  57. Maldonado PA, Wai CY. Pelvic organ prolapse new concepts in pelvic floor anatomy. Obstet Gynecol Clin North Am. 2016;43(1):15–26.

    Article  PubMed  Google Scholar 

  58. Lee U, Raz S. Emerging concepts for pelvic organ prolapse surgery: what is cure? Curr Urol Rep. 2011;12(1):62–7.

    Article  PubMed  Google Scholar 

  59. Elliott CS, Yeh J, Comiter CV, Chen B, Sokol ER. The predictive value of a cystocele for concomitant vaginal apical prolapse. J Urol. 2013;189(1):200–3.

    Article  PubMed  Google Scholar 

  60. Keys T, Campeau L, Badlani G. Synthetic mesh in the surgical repair of pelvic organ prolapse: current status and future directions. Urology. 2012;80:237–43.

    Article  PubMed  Google Scholar 

  61. Chapple CR, Cruz F, Deffieux X, et al. Consensus statement of the European Urology Association and the European Urogynaecological Association on the use of implanted materials for treating pelvic organ prolapse and stress urinary incontinence. Eur Urol. 2017;72(3):424–31. https://doi.org/10.1016/j.eururo.2017.03.048.

    Article  PubMed  Google Scholar 

  62. Boennelycke M, Gras S, Lose G. Tissue engineering as a potential alternative or adjunct to surgical reconstruction in treating pelvic prolapse. Int Urogynecol J. 2013;24(5):741–7.

    Article  CAS  PubMed  Google Scholar 

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Marzi, V.L., Frizzi, J., Campi, R., Serni, S. (2018). Transvaginal Mesh Repair for Pelvic Organ Prolapse: Toward a New Era. In: Li Marzi, V., Serati, M. (eds) Management of Pelvic Organ Prolapse. Urodynamics, Neurourology and Pelvic Floor Dysfunctions. Springer, Cham. https://doi.org/10.1007/978-3-319-59195-7_10

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  • DOI: https://doi.org/10.1007/978-3-319-59195-7_10

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