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International Urogynecology Journal

, Volume 22, Issue 5, pp 529–533 | Cite as

Ultrasound appearances after mesh implantation—evidence of mesh contraction or folding?

  • Kamil Svabík
  • Alois Martan
  • Jaromir Masata
  • Rachid El-Haddad
  • Petr Hubka
  • Marketa Pavlikova
Original Article

Abstract

Introduction and hypothesis

Polypropylene meshes are frequently used in abdominal and vaginal reconstructive surgery. Recently, several authors have claimed that mesh-associated complications may be linked to mesh shrinkage. We have performed a prospective study with postoperative follow-up by ultrasound examination at two time points after Prolift anterior implantation to assess changes in the ultrasound appearance of mesh implants over time.

Methods

We assessed 36 patients who had undergone mesh implantation with Prolift anterior mesh for the correction of symptomatic anterior vaginal wall prolapse. During the surgery, we measured the actual midline length of the mesh (initial length). On the fourth postoperative day, we performed a vaginal ultrasound examination (US) to measure mesh length in the midsagittal plane. A second US was performed 3–5 months after surgery to repeat this measurement.

Results

There was a significant difference in mesh length determined before and 4 days after surgery (90.3 vs. 57.1 mm, P = <0.0001) indicating intraoperative folding. On comparing early and late postoperative ultrasound measurements, there was a reduction in length from 57.1 to 48.3 mm (P < 0.0001), indicating possible shrinkage or retraction.

Conclusions

Intraoperative folding seems to be responsible for a large part of the difference between preoperative (in vitro) and postoperative (US) measurements of mesh dimensions, suggesting that surgical techniques may require adjustment.

Keywords

Prolift anterior Mesh shrinking Mesh retraction Vaginal ultrasound Vaginal surgery 

Abbreviations

POP-Q

Pelvic organ prolapse quantification system

US

Ultrasound

ICC

Intraclass correlation

CT

Computer tomography

MR

Magnetic resonance

Notes

Acknowledgements

This work was supported by the Grant Agency of the Ministry of Health of the Czech Republic, grant NR/9216-3.

Conflicts of interest

A. Martan provides consultation for Gynecare, Bard, and AMS.

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Copyright information

© The International Urogynecological Association 2010

Authors and Affiliations

  • Kamil Svabík
    • 1
  • Alois Martan
    • 1
  • Jaromir Masata
    • 1
  • Rachid El-Haddad
    • 1
  • Petr Hubka
    • 1
  • Marketa Pavlikova
    • 2
  1. 1.Department of Obstetrics and Gynecology, First Faculty of MedicineCharles University in Prague and General University HospitalPrague 2Czech Republic
  2. 2.EuroMISE CentreInstitute of Computer Science of the Academy of Sciences of the Czech RepublicPragueCzech Republic

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