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High complication rate identified in sacrocolpopexy patients attributed to silicone mesh.
Urology. 2005 Jun; 65(6):1099-103.U

Abstract

OBJECTIVES

To report on our experience using a preconfigured Y-shaped silicone-coated polyester mesh and polypropylene mesh for vaginal vault suspension. A variety of materials have been used for both open and laparoscopic sacrocolpopexy in the management of vaginal vault prolapse. Recently, a preconfigured Y-shaped silicone-coated polyester mesh was introduced to facilitate the vaginal cuff suspension to the sacrum.

METHODS

We reviewed the data of 45 consecutive patients who underwent abdominal (n = 28) or laparoscopic (n = 17) sacrocolpopexy. Of the 45 patients, 21 underwent silicone mesh suspension of the vaginal cuff to the anterior sacrum, with a mean follow-up of 23 months (range 16 to 41). A comparative analysis was performed of 24 patients who underwent the same procedure with polypropylene mesh.

RESULTS

Of the 21 patients in the silicone group, 5 (23.8%) have had a major complication (four vaginal mesh erosions and one mesh infection) after a median follow-up of 9.5 months (range 4 to 20). The presenting symptoms were persistent or new vaginal discharge and/or nonspecific pelvic pain. One patient underwent successful removal of the mesh transvaginally, but the rest required abdominal exploration. To date, the 24 patients who underwent vaginal cuff suspension with polypropylene mesh have had no vaginal mesh extrusions or infections, with a mean follow-up of 12 months (range 1 to 38).

CONCLUSIONS

Silicone-coated polyester mesh has recently been associated with a high rate of vaginal erosion when used as a transvaginal suburethral sling. Our experience specifically with vaginal vault suspension corroborates this. We have abandoned the use of silicone mesh because of the unacceptably high extrusion rate and presently use polypropylene mesh.

Authors+Show Affiliations

Govier FE
Department of Surgery, Continence Center, Virginia Mason Medical Center, Seattle, Washington 98111, USA. urofeg@vmmc.org
Kobashi KC
No affiliation info available
Kozlowski PM
No affiliation info available
Kuznetsov DD
No affiliation info available
Begley SJ
No affiliation info available
McGonigle KF
No affiliation info available
Muntz HG
No affiliation info available

MeSH

AgedAged, 80 and overCoated Materials, BiocompatibleDevice RemovalFemaleHumansMiddle AgedPolypropylenesReoperationSiliconesSurgical MeshUrogenital Surgical ProceduresUterine Prolapse

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15913735

Citation

Govier, Fred E., et al. "High Complication Rate Identified in Sacrocolpopexy Patients Attributed to Silicone Mesh." Urology, vol. 65, no. 6, 2005, pp. 1099-103.
Govier FE, Kobashi KC, Kozlowski PM, et al. High complication rate identified in sacrocolpopexy patients attributed to silicone mesh. Urology. 2005;65(6):1099-103.
Govier, F. E., Kobashi, K. C., Kozlowski, P. M., Kuznetsov, D. D., Begley, S. J., McGonigle, K. F., & Muntz, H. G. (2005). High complication rate identified in sacrocolpopexy patients attributed to silicone mesh. Urology, 65(6), 1099-103.
Govier FE, et al. High Complication Rate Identified in Sacrocolpopexy Patients Attributed to Silicone Mesh. Urology. 2005;65(6):1099-103. PubMed PMID: 15913735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High complication rate identified in sacrocolpopexy patients attributed to silicone mesh. AU - Govier,Fred E, AU - Kobashi,Kathleen C, AU - Kozlowski,Paul M, AU - Kuznetsov,Dimitri D, AU - Begley,Sean J, AU - McGonigle,Kathryn F, AU - Muntz,Howard G, PY - 2004/06/12/received PY - 2004/11/19/revised PY - 2004/12/10/accepted PY - 2005/5/26/pubmed PY - 2005/12/15/medline PY - 2005/5/26/entrez SP - 1099 EP - 103 JF - Urology JO - Urology VL - 65 IS - 6 N2 - OBJECTIVES: To report on our experience using a preconfigured Y-shaped silicone-coated polyester mesh and polypropylene mesh for vaginal vault suspension. A variety of materials have been used for both open and laparoscopic sacrocolpopexy in the management of vaginal vault prolapse. Recently, a preconfigured Y-shaped silicone-coated polyester mesh was introduced to facilitate the vaginal cuff suspension to the sacrum. METHODS: We reviewed the data of 45 consecutive patients who underwent abdominal (n = 28) or laparoscopic (n = 17) sacrocolpopexy. Of the 45 patients, 21 underwent silicone mesh suspension of the vaginal cuff to the anterior sacrum, with a mean follow-up of 23 months (range 16 to 41). A comparative analysis was performed of 24 patients who underwent the same procedure with polypropylene mesh. RESULTS: Of the 21 patients in the silicone group, 5 (23.8%) have had a major complication (four vaginal mesh erosions and one mesh infection) after a median follow-up of 9.5 months (range 4 to 20). The presenting symptoms were persistent or new vaginal discharge and/or nonspecific pelvic pain. One patient underwent successful removal of the mesh transvaginally, but the rest required abdominal exploration. To date, the 24 patients who underwent vaginal cuff suspension with polypropylene mesh have had no vaginal mesh extrusions or infections, with a mean follow-up of 12 months (range 1 to 38). CONCLUSIONS: Silicone-coated polyester mesh has recently been associated with a high rate of vaginal erosion when used as a transvaginal suburethral sling. Our experience specifically with vaginal vault suspension corroborates this. We have abandoned the use of silicone mesh because of the unacceptably high extrusion rate and presently use polypropylene mesh. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/15913735/High_complication_rate_identified_in_sacrocolpopexy_patients_attributed_to_silicone_mesh_ DB - PRIME DP - Unbound Medicine ER -