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International Urogynecology Journal

, Volume 28, Issue 2, pp 325–327 | Cite as

An innovative approach to treating vaginal mesh exposure after abdominal sacral colpopexy: endoscopic resection of mesh and platelet-rich plasma; initial experience in three women

  • Daniele CastellaniEmail author
  • Alessandra Valloni
  • Angela Piccirilli
  • Giuseppe Paradiso Galatioto
  • Carlo Vicentini
IUJ Video

Abstract

Introduction and hypothesis

Polypropylene mesh exposure is uncommon after abdominal sacral colpopexy (ASC), but in case of symptomatic vaginal mesh exposure, surgery is needed. When treating it, care must be taken to completely remove the exposed mesh (EM), saving as much vaginal tissue as possible to avoid a subsequent shortened and narrowed vagina. In this video, we present a minimally invasive technique for treating EM after ASC using endoscopic mesh resection and autologous platelet-rich plasma (PRP) technology.

Methods

Three women were referred to our outpatient clinic for vaginal vault mesh exposure after laparoscopic ASC with concomitant hysterectomy. All women underwent endoscopic bipolar PlasmaKinetic resection (BPR) of EM, and PRP gel was delivered in the surgical site to cover the gap left by the resection.

Results

Mean operative time was 39.6 min. Surgery was uneventful in all cases. All women recovered sexual function, and nobody experienced relapsed pelvic organ prolapse at 1-year follow-up.

Conclusions

Our preliminary results show that BPR and PRP are safe, effective, and feasible for treating vaginal mesh exposure with conservation of anatomy and sexual function.

Keywords

Mesh complication Natural orifice endoscopic surgery PlasmaKinetic energy Platelet-rich gel Platelet-rich plasma Sacrocolpopexy 

Notes

Acknowledgments

The authors would like to thank Dr. Davide Milardi for his outstanding contribution in video editing.

Compliance with ethical standards

Financial disclaimer

None.

Conflicts of interest

None.

Consent

Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

Supplementary material

ESM 1

(MP4 90791 kb)

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Copyright information

© The International Urogynecological Association 2016

Authors and Affiliations

  • Daniele Castellani
    • 1
    Email author
  • Alessandra Valloni
    • 1
  • Angela Piccirilli
    • 1
  • Giuseppe Paradiso Galatioto
    • 1
  • Carlo Vicentini
    • 1
  1. 1.Department of Life Health & Environmental SciencesUniversity of L’Aquila, Urology Unit, “Giuseppe Mazzini” HospitalTeramoItaly

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