Abstract
Transvaginal repair with mesh of pelvic organ prolapse (POP) provides women with the durability of a synthetic graft using the less-invasive route of vaginal surgery. However, morbidities such as mesh exposures are common and challenging to manage. Small intestinal submucosa (SIS) is a naturally occurring collagen matrix derived from porcine intestine. It contains growth factors and cytokines that promote healing of damaged tissue. This case report describes a large vaginal mesh exposure due to necrosis of the full thickness of the anterior vaginal wall. A remarkable and rapid regeneration of vaginal tissue over the exposed mesh was achieved with SIS placement after failure of treatment with vaginal estrogen for >6 months. Collagen scaffold is an effective, rapid, and minimally invasive treatment for large vaginal mesh exposures.
References
Clemons JL, Weinstein M, Guess MK, Alperin M, Moalli P, Gregory WT et al (2013) Impact of the 2011 FDA transvaginal mesh safety update on AUGS members' use of synthetic mesh and biologic grafts in pelvic reconstructive surgery. Female Pelvic Med Reconstr Surg 19(4):191–198
Abed H, Rahn DD, Lowenstein L, Balk EM, Clemons JL, Rogers RG (2011) Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Int Urogynecol J 22(7):789–798
Tijdink MM, Vierhout ME, Heesakkers JP et al (2011) Surgical management of mesh-related complications after prior pelvic floor reconstructive surgery with mesh. Int Urogynecol J 22:1395–1404
Brown BN, Badylak SF (2014) Extracellular matrix as an inductive scaffold for functional tissue reconstruction. Transl Res 163(4):268–285
Khong SY, Lam A (2011) Use of Surgisis mesh in the management of polypropylene mesh erosion into the vagina. Int Urogynecol J 22(1):41–46
Shaker D (2010) Surgical management of vaginal mesh erosion: an alternative to excision. Int Urogynecol J 21(4):499–501
Conflict of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Alperin, M. Collagen scaffold: a treatment for large mesh exposure following vaginal prolapse repair. Int Urogynecol J 25, 1597–1599 (2014). https://doi.org/10.1007/s00192-014-2427-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-014-2427-5