International Urogynecology Journal

, Volume 22, Issue 1, pp 41–46 | Cite as

Use of Surgisis mesh in the management of polypropylene mesh erosion into the vagina

Original Article

Abstract

Introduction and hypothesis

Mesh in pelvic reconstructive surgery is being used increasingly in clinical practice. Complications such as mesh erosion and dyspareunia can cause significant patient morbidity. In cases where vaginal mesh erosions are large or multifocal resulting in inadequate healthy epithelium for repair, this may lead to recurrent mesh erosion or vaginal stenosis.

Method

Nine patients with synthetic mesh erosion who failed to respond to conservative measures were managed surgically with Surgisis.

Results

The median time at which patients presented with mesh erosion was 12 weeks. The size of erosion ranged from 1 to 4 cm in diameter. At follow-up, five patients were cured, three still had evidence of mesh erosion although the overall defects were smaller, and one patient required further surgery.

Conclusion

With mesh erosion being a troublesome reality following insertion of synthetic mesh repairs, Surgisis may prove to be a useful option in the treatment of large vaginal mesh defects.

Keywords

Complication Mesh Erosion Surgisis Polypropylene Vagina 

Notes

Conflicts of interest

None.

References

  1. 1.
    Birch C (2005) The use of prosthetics in pelvic reconstructive surgery. Best Pract Res Clin Obst Gyn 19(6):979–991CrossRefGoogle Scholar
  2. 2.
    Ng CC, Chong CY (2006) The effectiveness of transvaginal anterior colporrhaphy reinforced with polypropylene mesh in the treatment of severe cystocoeles. Ann Acad Med Singapore 35:875–881PubMedGoogle Scholar
  3. 3.
    Defflieux X, de Tayrac R, Huel C, Bottero J, Gervaise A, Bonnet K et al (2007) Vaginal mesh erosion after transvaginal repair of cystocoele using Gynemesh or Gynemesh- Soft in 138 women: a comparative study. Int Urogynecol J 18:73–91CrossRefGoogle Scholar
  4. 4.
    Boyles SH, McCrery R (2008) Dyspareunia and mesh erosion after vaginal mesh placement with a kit procedure. Obst Gynaecol 111(4):969–975CrossRefGoogle Scholar
  5. 5.
    Gonsalves S, Sagar P, Lengyel J, Morrison C, Dunham R (2009) Assessment of the efficacy of the rectovaginal button fistula plug for the treatment of ileal pouch-vaginal and rectovaginal fistulas. Dis Colon Rectum 52(11):1877–1881PubMedGoogle Scholar
  6. 6.
    Rutner AB, Levine SR, Schmaelzle JF (2003) Processed procine small intestinal submucosa as a graft material for pubovaginal slings: durability and results. Urology 62(5):805–809CrossRefPubMedGoogle Scholar
  7. 7.
    Chaliha C, Khalid U, Campagna L, Digesu GA, Ajay B, Khullar V (2006) SIS graft for anterior vaginal wall prolapse repair- a case-controlled study. Int Urogynecol J 17:492–497CrossRefGoogle Scholar
  8. 8.
    Franklin ME Jr, Trevino JM, Portillo G, Vela I, Glass JL, González JJ (2008) The use of porcine small intestinal submucosa as a prosthetic material for laparoscopic hernia repair in infected and potentially contaminated fields: long term follow-up. Surg Endosc 22(9):1941–1946CrossRefPubMedGoogle Scholar
  9. 9.
    Ellis N (2008) Outcomes after repair of rectovaginal fistulas using bioprosthetics. Dis Colon Rectum 51(7):1084–1088CrossRefPubMedGoogle Scholar
  10. 10.
    O’Connor RC, Hollowell CM, Steinberg GD (2002) Distal ureteral replacement with tabularized porcine small intestine submucosa. Urology 60:697CrossRefPubMedGoogle Scholar
  11. 11.
    Lee JW, Doumouchtsis SK, Fynes MM (2009) A modified technique for the surgical correction of urethral diverticula using a porcine xenograft. Int Urogynecol J 20(1):117–120CrossRefGoogle Scholar
  12. 12.
    Mostow EN, Haraway GD, Dalsing M, Hodde JP, King D (2005) Effectiveness of an extracellular matrix graft (OASIS Wound Matrix) in the treatment of chronic leg ulcers: a randomized clinical trial. J Vasc Surg 41(5):837–843CrossRefPubMedGoogle Scholar
  13. 13.
    Niezgoda JA, Van Gils CC, Frykberg RG, Hodde JP (2005) Randomized clinical trial comparing OASIS Wound Matrix to Regranex Gel for diabetic ulcers. Adv Skin Wound Care 18(5 pt 1):258–266CrossRefPubMedGoogle Scholar
  14. 14.
    Romanelli M, Dini V, Bertone M et al (2007) OASIS Wound Matrix versus Hyaloskin in the treatment of difficult-to-heal wounds in mixed arterial/venous aetiology. Int Wound J 4(1):3–7CrossRefPubMedGoogle Scholar
  15. 15.
    Julian TM (1996) The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475CrossRefPubMedGoogle Scholar
  16. 16.
    Shaker D (2009) Surgical management of vaginal mesh erosion: an alternative to excision. Int Urogynecol J 21(4):499–501CrossRefGoogle Scholar
  17. 17.
    Kohli N, Miklos JR (2001) Use of synthetic mesh and donor grafts in gynecologic surgery. Curr Womens Health Rep 1(1):53–60PubMedGoogle Scholar
  18. 18.
    Trabuco EC, Klingele CJ, Gebhart JB (2007) Xenograft use in reconstructive pelvic surgery: a review of the literature. Int Urogynecol J 18:555–563CrossRefGoogle Scholar
  19. 19.
    Clarke KM, Lantz GC, Salisbury SK, Badylak SF, Hiles MC, Voylik SL (1996) Intestinal submucosa and polypropylene mesh for abdominal repair in dogs. J Surg Res 60:107–114CrossRefPubMedGoogle Scholar
  20. 20.
    Selvaggi G, Monstrey S, Van Landuyt K, Hamdi M, Blondeel P (2003) The role of iodine in antisepsis. Acta Chir Belg 103(3):241–247PubMedGoogle Scholar
  21. 21.
    Davila GW, Ghoniem GM, Kapoor DS, Contreras-Ortiz O (2002) Pelvic Floor dysfunction management practice patterns: a survey of members of the International Urogynecological Association. Int Urogynecol J J13:319–325CrossRefGoogle Scholar
  22. 22.
    Ganj FA, Ibeanu OA, Bedestani A, Nolan TE, Chesson RR (2009) Complications of transvaginal monofilament polypropylene mesh in pelvic organ prolapse repair. Int Urogynecol J 20(8):919–925CrossRefGoogle Scholar
  23. 23.
    Collinet P, Belot F, Debodinance P, Ha Duc E, Lucot JP, Cosson M (2006) Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J 17(4):315–320CrossRefGoogle Scholar
  24. 24.
    Marinkovic SP (2008) Will hysterectomy at the time of sacrocolpopexy increase the rate of polypropylene mesh erosion? Int Urogynecol J 19(2):199–203CrossRefGoogle Scholar
  25. 25.
    Stepanian AA, Miklos JR, Moore RD, Mattox TF (2008) Risk of mesh extrusion and othermesh-related complications after laparoscopic sacral colpopexy with or without concurrent laparoscopic-assisted vaginal hysterectomy: experience of 402 patients. J Minim Invasive Gynecol 15(2):188–196CrossRefPubMedGoogle Scholar
  26. 26.
    Mouritsen L, Kronschnabl M, Lose G (2009) Long-term results of vaginal repairs with and without xenograft reinforcement. Int Urogynecol J 21(4):467–473CrossRefGoogle Scholar
  27. 27.
    Badylak S, Kokini K, Tullius B, Whitson B (2001) Strength over time of a resorbable bioscaffold for body wall repairin a dog model. J Surg Res 99:282–287CrossRefPubMedGoogle Scholar
  28. 28.
    Konstantinovic ML, Ozog Y, Spelzini F, Pottier C, De Ridder D, Deprest J (2009) Biomechanical findings in rats undergoing fascial reconstruction with graft materials suggested as an alternative to polypropylene. Neurourol Urodyn 29(3):488–493Google Scholar

Copyright information

© The International Urogynecological Association 2010

Authors and Affiliations

  1. 1.Centre for Advanced Reproductive EndosurgeryAMA BuildingSt. LeonardsAustralia

Personalised recommendations