The Use of Synthetic Polymer Meshes in the Correction of Pelvic Static Defects

Bratila, Elvira; Bratila, Cornel Petre; Comandasu, Diana Elena; Antoniac, Aurora; Cirstoiu, Monica Mihaela

Elvira Bratila, Cornel Petre Bratila, Diana Elena Comandasu, Aurora Antoniac, Monica Mihaela Cirstoiu

The Use of Synthetic Polymer Meshes in the Correction of Pelvic Static Defects

Abstract:
The purpose of this paper is to prove that the use of synthetic meshes in the treatment of pelvic organ prolapse involves specific complications. Pelvic organ prolapse occurs as a result of the distention or rupture of a weakened, inelastic connective tissue that is a major compound of fascia and ligaments which make up the support and suspension system of pelvic organs. Pelvic organ prolapse has genetic determinism and so patients who suffer from it produce a poor quality collagen or it may happen due to premature aging. The risk for a woman to develop various stages of prolapse is appreciated to be 11% and the risk of relapse is 29.25%. Unlike in case of other surgical treated afflictions, pelvic organ prolapse has a very high risk of relapses that need surgical cure - 17%. The failure rate of the traditional surgical treatment using native tissues is 58% for the anterior pelvic compartment. Given the circumstances strengthening the weakened fascia and ligaments using biological grafts or synthetic ones proved itself necessary. The first augmentation attempts using synthetic meshes were performed by Manhes in 1990. Currently the synthetic meshes are widely used and have good outcomes, but they also have specific complications. For transvaginal interventions reconstruction using meshes is superior to the procedures that use native tissues. Surgical treatment for the pelvic floor defects consisting in synthetic mesh implant shall not be recommended unless the benefits exceed the risks for every case in particular. Based on our experimental results, scanning electron microscopy appears to be a very useful tool for surface analysis and retrieval studies of the surgical mesh used in the treatment of pelvic floor defects. Also, we find that the mesh erosion is the main adverse effect in the surgical treatment of pelvic floor defects and this appears due to the polymeric mesh materials modifications.

Keywords:
artificial meshes; polymer; pelvic organ prolapse; erosion; pelvic pain

Issue: 2016 Volume 53, Issue 4

Pages: 626-631

Publication date: 2016/12/30