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Colin Birch. The use of prosthetics in pelvic reconstructive surgery


Best Practice & Research Clinical Obstetrics and Gynecology Vol.
19, N 6, pp. 979-991, 2005

1 11
30%



(< 2-3 ),

,

MESH:
100%

25%
75%


MESH

Impact of menopause on collagen subtypes in the arcus


tendineous fasciae pelvis
P. A. Moalli, and all.
American Journal of Obstetrics and Gynecology Volume 190, Issue 3 , March 2004, Pages 620-627

Pubocervical fascia

Paravaginal defect

Arcus tendineus fascia


pelvis (ATPF)

Lig. Sacro-spinale

MESH:

MESH:

MESH:

MESH
1903 ()

1800 ..
400


1938 Nylon
1956 Dacron
(Mersilene)
1958 - Marlex

MESH:
Maher C. at all Surgical management of anterior
vaginal wall prolapse in women. Cochrane Syst.
Rev. 2004

MESH
MESH


(> 90%) SSP

MESH

MESH

MESH
S y n t h e t ic
A b s o r b a b le

P o ly g la c t in

P o ly g ly c o lic a c id

N o n - a b s o r b a b le
M u lt i

M ono

M ix e d
V ip r o
V ip r o I I


MESH

TV MESH

MESH:
Coda A. at all. Structural alteration of
prosthetic meshes in humans. Hernia 2003,
7, 29-34
Trelex (

) 40
60%
Prolen 58%

MESH:

MESH
MESH 6%
(, , )


(
, ..)

MESH:

MESH:

Summary

Range

Median

Bladder Perforation

0 5,3%

Vascular Injury

Neurological Injury

Haemorrhage

0 3,3%

Vaginal Perforation

0 1,8%

Urethral Injury

0 1,5%

Rectal injury

0 1,6%

Vesical injury

0 1,3%

Haematoma

0 4%

0,8

Summary

Range

Median

Urinary tract Infection

0 11,8%

Wound Infection

0 0,4%

De Novo SUI

0 9,7%

4,1

De Novo Urge

0 11%

Pain

0 34,7%

1,7

Shrinkage
(Treated and non-treated)

0 17%

Erosion

0 12,3%

5,3

Dyspareunia

2,8 6,3%

4,2

Fistula

0 2,2%

Abscess

0 3,9%

Cellulitis

0 0,15%

Retention

0 26,9%

MESH

MESH
MESH

MESH:

MESH:

MESH:

MESH:

MESH:
:
-
-
-
-
-


(>70 )



TV MESH
( 4 10%)

MESH:
(

MESH?)


MESH?

MESH
de Tayrac R. at all Prolapse repair by vaginal route using a
new protected low-weight polypropylane mesh: 1-year
functional and anatomical outcome in a prospective
multicentre study
Int. Urogynecol. J Pelvic Floor Dysfunction 2006
20%

MESH
88%
MESH

12% de novo

MESH

MESH
(
)

,

MESH
MESH

I

,

The Future
Mesh

.

.

The Future

?
mesh

Change may not always be good..

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