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International Urogynecology Journal

, Volume 28, Issue 8, pp 1131–1138 | Cite as

MRI visible Fe3O4 polypropylene mesh: 3D reconstruction of spatial relation to bony pelvis and neurovascular structures

  • Luyun Chen
  • Florian Lenz
  • Céline D. Alt
  • Christof Sohn
  • John O. De Lancey
  • Kerstin A. BrockerEmail author
Original Article

Abstract

Introduction and hypothesis

To demonstrate mesh magnetic resonance imaging (MRI) visibility in living women, the feasibility of reconstructing the full mesh course in 3D, and to document its spatial relationship to pelvic anatomical structures.

Methods

This is a proof of concept study of three patients from a prospective multi-center trial evaluating women with anterior vaginal mesh repair using a MRI-visible Fe3O4 polypropylene implant for pelvic floor reconstruction. High-resolution sagittal T2-weighted (T2w) sequences, transverse T1-weighted (T1w) FLASH 2D, and transverse T1w FLASH 3D sequences were performed to evaluate Fe3O4 polypropylene mesh MRI visibility and overall post-surgical pelvic anatomy 3 months after reconstructive surgery. Full mesh course in addition to important pelvic structures were reconstructed using the 3D Slicer® software program based on T1w and T2w MRI.

Results

Three women with POP-Q grade III cystoceles were successfully treated with a partially absorbable MRI-visible anterior vaginal mesh with six fixation arms and showed no recurrent cystocele at the 3-month follow-up examination. The course of mesh in the pelvis was visible on MRI in all three women. The mesh body and arms could be reconstructed allowing visualization of the full course of the mesh in relationship to important pelvic structures such as the obturator or pudendal vessel nerve bundles in 3D.

Conclusions

The use of MRI-visible Fe3O4 polypropylene meshes in combination with post-surgical 3D reconstruction of the mesh and adjacent structures is feasible suggesting that it might be a useful tool for evaluating mesh complications more precisely and a valuable interactive feedback tool for surgeons and mesh design engineers.

Keywords

3D mesh reconstruction Fe3O4 MRI-visible anterior mesh Pelvic floor mesh surgery Pelvic organ prolapse 

Notes

Acknowledgements

We thank Dr A. Maleika (Director of the Department of Obstetrics and Gynecology, Hospital Schwetzingen, Germany) for her assistance in patient recruitment for this trial. Dr J. DeLancey and Dr L. Chen acknowledge support from the Office for Research on Women’s Health Special Center of Research Grant at the NIH P50 HD 44406 and R21 HD079908.

Compliance with ethical standards

Financial disclaimers

KAB and FL received speaking honoraria from the company Serag Wiessner (Naila, Germany). FL received speaking honoraria from American Medical Systems, USA, and C.R. BARD, Karlsruhe, Germany. No money from speaking honoraria was used to fund this trial. KAB has received research funding from Serag Wiessner in the past, none of which was used to perform this trial. KAB received a scholarship from the organization Forum urodynamicum e.V. to complete this work. CDA and CS state that they have nothing to disclose.

Supplementary material

(MP4 31774 kb)

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Copyright information

© The International Urogynecological Association 2017

Authors and Affiliations

  • Luyun Chen
    • 1
  • Florian Lenz
    • 2
  • Céline D. Alt
    • 3
  • Christof Sohn
    • 4
  • John O. De Lancey
    • 5
  • Kerstin A. Brocker
    • 4
    Email author
  1. 1.Pelvic Floor Research Group, Biomedical Engineering DepartmentUniversity of MichiganAnn ArborUSA
  2. 2.Department of Obstetrics and Gynecology, St Marienkrankenhaus LudwigshafenAcademic Teaching Hospital of the Faculty of Medicine Mannheim of the University Medical School HeidelbergLudwigshafen am RheinGermany
  3. 3.Medical Faculty, Department of Diagnostic and Interventional RadiologyUniversity DüsseldorfDüsseldorfGermany
  4. 4.Medical School, Department of Obstetrics and GynecologyUniversity of HeidelbergHeidelbergGermany
  5. 5.Obstetrics and Gynecology Department, Pelvic Floor Research GroupUniversity of MichiganAnn ArborUSA

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