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A Novel Operative Procedure for Pelvic Organ Prolapse Utilizing a MRI-Visible Mesh Implant: Safety and Outcome of Modified Laparoscopic Bilateral Sacropexy.

Joukhadar R, Meyberg-Solomayer G, Hamza A, Radosa J, Bader W, Barski D, Ismaeel F, Schneider G, Solomayer E, Baum S - Biomed Res Int (2015)

Bottom Line: Anatomical success was defined as POP-Q stage 0-I.MLBS is a feasible and safe procedure with favorable anatomical and functional outcome and good concomitant healing rates of SUI and OAB.Prospective data and larger samples are required.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University Hospital Homburg, Kirrberger Straße 100, 66424 Homburg, Germany.

ABSTRACT

Introduction: Sacropexy is a generally applied treatment of prolapse, yet there are known possible complications of it. An essential need exists for better alloplastic materials.

Methods: Between April 2013 and June 2014, we performed a modified laparoscopic bilateral sacropexy (MLBS) in 10 patients using a MRI-visible PVDF mesh implant. Selected patients had prolapse POP-Q stages II-III and concomitant OAB. We studied surgery-related morbidity, anatomical and functional outcome, and mesh-visibility in MRI. Mean follow-up was 7.4 months.

Results: Concomitant colporrhaphy was conducted in 1/10 patients. Anatomical success was defined as POP-Q stage 0-I. Apical success rate was 100% and remained stable. A recurrent cystocele was seen in 1/10 patients during follow-up without need for intervention. Out of 6 (6/10) patients with preoperative SUI, 5/6 were healed and 1/6 persisted. De-novo SUI was seen in 1/10 patients. Complications requiring a relaparoscopy were seen in 2/10 patients. 8/10 patients with OAB were relieved postoperatively. The first in-human magnetic resonance visualization of a prolapse mesh implant was performed and showed good quality of visualization.

Conclusion: MLBS is a feasible and safe procedure with favorable anatomical and functional outcome and good concomitant healing rates of SUI and OAB. Prospective data and larger samples are required.

No MeSH data available.


Related in: MedlinePlus

Coronal subvolume minimum intensity projection of a T2-weighted dataset, displaying the implant with a low signal intensity (arrows), comparable to the signal of muscle tissue.
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fig6: Coronal subvolume minimum intensity projection of a T2-weighted dataset, displaying the implant with a low signal intensity (arrows), comparable to the signal of muscle tissue.

Mentions: Regarding early complications, one (1/10) patient suffered from paresthesia of the right thigh. We performed a MRI that revealed the implanted mesh in the desired lay and ruled out any neural compression or hematoma (Figures 6 and 7).


A Novel Operative Procedure for Pelvic Organ Prolapse Utilizing a MRI-Visible Mesh Implant: Safety and Outcome of Modified Laparoscopic Bilateral Sacropexy.

Joukhadar R, Meyberg-Solomayer G, Hamza A, Radosa J, Bader W, Barski D, Ismaeel F, Schneider G, Solomayer E, Baum S - Biomed Res Int (2015)

Coronal subvolume minimum intensity projection of a T2-weighted dataset, displaying the implant with a low signal intensity (arrows), comparable to the signal of muscle tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4417564&req=5

fig6: Coronal subvolume minimum intensity projection of a T2-weighted dataset, displaying the implant with a low signal intensity (arrows), comparable to the signal of muscle tissue.
Mentions: Regarding early complications, one (1/10) patient suffered from paresthesia of the right thigh. We performed a MRI that revealed the implanted mesh in the desired lay and ruled out any neural compression or hematoma (Figures 6 and 7).

Bottom Line: Anatomical success was defined as POP-Q stage 0-I.MLBS is a feasible and safe procedure with favorable anatomical and functional outcome and good concomitant healing rates of SUI and OAB.Prospective data and larger samples are required.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University Hospital Homburg, Kirrberger Straße 100, 66424 Homburg, Germany.

ABSTRACT

Introduction: Sacropexy is a generally applied treatment of prolapse, yet there are known possible complications of it. An essential need exists for better alloplastic materials.

Methods: Between April 2013 and June 2014, we performed a modified laparoscopic bilateral sacropexy (MLBS) in 10 patients using a MRI-visible PVDF mesh implant. Selected patients had prolapse POP-Q stages II-III and concomitant OAB. We studied surgery-related morbidity, anatomical and functional outcome, and mesh-visibility in MRI. Mean follow-up was 7.4 months.

Results: Concomitant colporrhaphy was conducted in 1/10 patients. Anatomical success was defined as POP-Q stage 0-I. Apical success rate was 100% and remained stable. A recurrent cystocele was seen in 1/10 patients during follow-up without need for intervention. Out of 6 (6/10) patients with preoperative SUI, 5/6 were healed and 1/6 persisted. De-novo SUI was seen in 1/10 patients. Complications requiring a relaparoscopy were seen in 2/10 patients. 8/10 patients with OAB were relieved postoperatively. The first in-human magnetic resonance visualization of a prolapse mesh implant was performed and showed good quality of visualization.

Conclusion: MLBS is a feasible and safe procedure with favorable anatomical and functional outcome and good concomitant healing rates of SUI and OAB. Prospective data and larger samples are required.

No MeSH data available.


Related in: MedlinePlus