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International Urogynecology Journal

, Volume 28, Issue 8, pp 1153–1158 | Cite as

Effect of mesh width on apical support after sacrocolpopexy

  • Sunil Balgobin
  • Joseph L. Fitzwater
  • Donald D. McIntire
  • Imelda J. Delgado
  • Clifford Y. Wai
Original Article

Abstract

Introduction and hypothesis

We evaluated the effect of polypropylene mesh width on vaginal apical support, mesh elongation, and mesh tensile strength for abdominal sacrocolpopexy.

Methods

Abdominal sacrocolpopexy was performed on ten cadavers using pieces of polypropylene mesh of width 1, 2, and 3 cm. Weights of 1, 2, 3, and 4 kg were sequentially applied to the vagina. The total distance moved by the vaginal apex, and the amount of stretch of the intervening mesh segment between the sacrum and the vagina were recorded for each width. The failure strengths of additional single and double layer sets of each width were also tested using a tensiometer. Data were analyzed with analysis of variance using a random effects model.

Results

The mean (standard error of the mean) maximum distance moved by the vaginal apex was 4.63 cm (0.37 cm) for the 1 cm mesh compared to 3.67 cm (0.26 cm) and 2.73 cm (0.14 cm) for the 2 and 3 cm meshes, respectively (P < 0.0001). The 1 cm width ruptured during testing in four of the ten cadavers. The results were similar for mesh elongation, with the 1 cm mesh stretching the most and the 3 cm mesh stretching the least. Mesh failure loads for double-layer mesh were 52.9 N (2.5 N), 124.4 N (2.7 N), and 201.2 N (4.5 N) for the 1, 2, and 3 cm meshes, respectively, and were higher than the failure loads for single mesh (P < 0.001).

Conclusions

In a cadaver model, increasing mesh width is associated with better vaginal apical support, less mesh elongation, and higher failure loads. Mesh widths of 2–3 cm provide sufficient repair strength for sacrocolpopexy.

Keywords

Biomechanics Mesh width Polypropylene mesh Sacrocolpopexy 

Notes

Compliance with ethical standards

Financial disclaimer

None.

Conflicts of interest

None.

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Copyright information

© The International Urogynecological Association 2016

Authors and Affiliations

  • Sunil Balgobin
    • 1
  • Joseph L. Fitzwater
    • 1
  • Donald D. McIntire
    • 1
  • Imelda J. Delgado
    • 2
  • Clifford Y. Wai
    • 1
  1. 1.Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and GynecologyUniversity of Texas Southwestern Medical CenterDallasUSA
  2. 2.Department of Plastic SurgeryUniversity of Texas Southwestern Medical CenterDallasUSA

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