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International Urogynecology Journal

, Volume 8, Issue 2, pp 105–115 | Cite as

The use of mesh in gynecologic surgery

  • C. B. Iglesia
  • D. E. Fenner
  • L. Brubaker
Review Article

Abstract

The aim of this review was to compare properties of the most commonly used synthetic meshes and describe their use in gynecologic procedures. An Ovid search of the English literature from 1966 to the present was carried out, together with a hand search ofIndex Medicus from 1950 to 1965. Articles involving the use of mesh in surgical procedures or comparative studies of the different mechanical properties of mesh are included. Overviews from urogynecologic texts and surgical texts are also included. All studies in this review consisted of retrospective case series (21 suburethral sling articles, 15 sacrocolpopexy articles, and five pelvic sling articles). No randomized prospective trials were available. Outcome variables, including cure rates and mesh-related complications, are reviewed and compared. Conclusions show that long-term success of the suburethral sling with synthetic mesh ranges from 61% to 100%, and the success rate of the abdominal sacrocolpopexies using mesh ranges from 68% to 100%. Mesh-related complications rates are frequent, with up to a 35% removal rate and 10% sinus tract formation for suburethral slings and 9% erosion rate for sacrocolpopexy. The ideal synthetic mesh material for pelvic surgery, one that induces minimal foreign-body reaction with minimal risk of infection, rejection and erosion, has yet to be developed.

Keywords

Gore-tex Marlex Mersilene Sacrocolpopexy Suburethral sling 

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References

  1. 1.
    Walker AP. Biomaterials in hernia repair. In Nyhus LM, Condon RF, eds. Hernia, 4th edn. Philadelphia: JB Lippincott Company, 1995;534–540Google Scholar
  2. 2.
    Smith RS. The use of prosthetic materials in the repair of hernias.Surg Clin North Am 1971;51:1387–1399PubMedGoogle Scholar
  3. 3.
    Hannah SI, Chin A. Laparoscopic retropubic urethropexy.J Am Assoc Gynecol Laparoscopists 1996;4:47–52CrossRefGoogle Scholar
  4. 4.
    Surgical Membrane Study Group. Prophylaxis of pelvic sidewall adhesions with Gore-tex surgical membrane: a multicenter clinical investigation.Fertil Steril 1992;7:921–923Google Scholar
  5. 5.
    Cali RL, Pitsch RM, Blatchford GJ et al. Rare pelvic floor hernias: report of a case and review of the literature.Dis Colon Rectum 1992;35:604–612PubMedCrossRefGoogle Scholar
  6. 6.
    Cumberland VH. A preliminary report on the use of prefabricated nylon weave in the repair of ventral hernia.Med J Aust 1952;1:143–144PubMedGoogle Scholar
  7. 7.
    Scales JT. Materials for hernia repair.Proc Roy Soc Med 1953;46:647–652PubMedGoogle Scholar
  8. 8.
    Brun JL, Bordenave L, Lefebvre F et al. Physical and biological characteristics of the main biomaterials used in pelvic surgery.Bio-Med Mat Eng 1992;2:203–225Google Scholar
  9. 9.
    Pourdeyhimi B. Porosity of surgical mesh fabrics: new technology.J Biomed Mater Res 1989;23:145–152PubMedCrossRefGoogle Scholar
  10. 10.
    Chu CC, Welch L. Characterization of morphologic and mechanical properties of surgical mesh fabrics.J Biomed Mat Res 1985;19:903–916CrossRefGoogle Scholar
  11. 11.
    Voyles CR, Richardson JD, Bland KI et al. Emergency abdominal wall reconstruction with polypropylene mesh: short-term benefits versus long-term complications.Ann Surg 1981;194:219–223PubMedCrossRefGoogle Scholar
  12. 12.
    Atrium polypropylene mesh monograph. 1996; Section 3:1–11.Google Scholar
  13. 13.
    DiBenedetto A, Fleischer A. Biological properties of surgical mesh. In: Rubin LM, ed. Biomaterials in reconstructive surgery. St. Louis: CV Mosby, 1983;819–829Google Scholar
  14. 14.
    Elliott MP, Juler GL. Comparison of Marlex mesh and microporous Teflon sheets when used for hernia repair in the experimental animal.Am J Surg 1979;137:342–344PubMedCrossRefGoogle Scholar
  15. 15.
    Usher FC. The repair of incisional and inguinal hernias.Surg Gynecol Obstet 1970;131:525–530PubMedGoogle Scholar
  16. 16.
    Moir, JC. The gauze-hammock operation.J Obstet Gynecol Br Common 1968;75(1):1–9Google Scholar
  17. 17.
    Morgan JE. A sling operation, using Marlex polypropylene mesh, for treatment of recurrent stress incontinence.Am J Obstet Gynecol 1070;106:369–377Google Scholar
  18. 18.
    Morgan JE, Farrow GA, Stewart FE. The Marlex sling operation for the treatment of recurrent stress urinary incontinence: a 16 year review.Am J Obstet Gynecol 1985;151:224–226PubMedGoogle Scholar
  19. 19.
    Drutz HP, Buckspan M, Flax S et al. Clinical and urodynamic reevaluation of combined abdominovaginal Marlex sling operations for recurrent stress urinary incontinence.Int Urogynecol J 1990;1:70–73CrossRefGoogle Scholar
  20. 20.
    Hilton P, Stanton SL. Clinical and urodynamic evaluation of the polypropylene (Marlex) sling for genuine stress incontinence.Neurourol Urodyn 1983;2:145–153CrossRefGoogle Scholar
  21. 21.
    Grunsdell H, Larsson G. Operative management of vaginal vault prolapse following hysterectomy.Br J Obstet Gynaecol 1994;91:808–811Google Scholar
  22. 22.
    Drutz HP, Cha LS. Massive genital and vaginal vault prolapse treated by abdominal-vaginal sacropexy with use of Marlex mesh: review of the literature.Am J Obstet Gynecol 1987;156:387–392PubMedGoogle Scholar
  23. 23.
    Parker MC, Phillips RKC. Repair of rectocele using Marlex mesh. Ann Roy Coll Surg Engl 1993;75:193–194Google Scholar
  24. 24.
    Ridley, JH. Appraisal of the Goebell-Stoeckel sling procedure.Am J Obstet Gynecol 1996;95:714–721Google Scholar
  25. 25.
    Kersey J. The gauze hammock sling operation in the treatment of stress incontinence.Br J Obstet Gynaecol 1983;90:945–949PubMedGoogle Scholar
  26. 26.
    Kersey J, Martin MR, Mishra P. A further assessment of the gauze hammock sling operation in the treatment of stress incontinence.Br J Obstet Gynaecol 1988;95:382–385PubMedGoogle Scholar
  27. 27.
    Young SB, Rosenblatt PL, Pingeton DM et al. The Mersilene mesh suburethral sling: a clinical and urodynamic evaluation.Am J Obstet Gynecol 1995;173:1719–1726PubMedCrossRefGoogle Scholar
  28. 28.
    Addison WA, Livengood CH, Sutton GP et al. Abdominal sacral colpopexy with Mersilene mesh in the retroperitoneal position in the management of posthysterectomy vaginal vault prolapse and enterocele.Obstet Gynecol 1985;153:140–146Google Scholar
  29. 29.
    Timmons MC, Addison WA, Addison SB et al. Abdominal sacral colpopexy in 163 women with posthysterectomy vaginal vault prolapse and enterocele: evolution of operative techniques.J Reprod Med 1992;37:323–327PubMedGoogle Scholar
  30. 30.
    Kelly GL, Eiseman B. Development of a new vascular prosthetic: lessons learned.Arch Surg 1982;117:1367–1370PubMedGoogle Scholar
  31. 31.
    Brown GL, Richardson D, Malangoni MA et al. Comparison of prosthetic materials for abdominal wall reconstruction in the presence of contamination and infection.Ann Surg 1985;201:705–711PubMedCrossRefGoogle Scholar
  32. 32.
    Horbach NS, Blanco JS, Ostergard DR et al. A suburethral sling procedure with polytetrafluoroethylene for the treatment of genuine stress incontinence in patients with low urethral closure pressure.Obstet Gynecol 1988;71:648–652PubMedGoogle Scholar
  33. 33.
    Summitt RL, Bent AE, Ostergard DR et al. Suburethral sling procedure for genuine stress incontinence and low urethral closure pressure. A continued experience.Int Urogynecol J 1992;3:18–21CrossRefGoogle Scholar
  34. 34.
    Bent AE, Ostergard DR, Zwick-Zaffutto M. Tissue reaction to expanded polytetrafluoroethylene suburethral sling for urinary incontinence: clinical and histological study.Am J Obstet Gynecol 1993;169:1198–1204PubMedGoogle Scholar
  35. 35.
    Weinberger MW, Ostergard DR. Postoperative catheterization, urinary retention, and permanent voiding dysfunction after poly-tetrafluoroethylene suburethral sling placement.Obstet Gynecol 1996;83:50–54CrossRefGoogle Scholar
  36. 36.
    Weinberger MW, Ostergard DR. Long-term clinical and urodynamic evaluation of the polytetrafluoroethylene sling for treatment of genuine stress incontinence.Obstet Gynecol 1995;86:92–96PubMedCrossRefGoogle Scholar
  37. 37.
    Snyder, TE, Krantz KE. Abdominal-retroperitoneal sacral colpopexy for the correction of vaginal prolapse.Obstet Gynecol 1991;77:944–949PubMedGoogle Scholar
  38. 38.
    Imparato E, Aspesi G, Rovetta E et al. Surgical management and prevention of vaginal vault prolapse.Surg Gynecol Obstet 1992;175:233–237PubMedGoogle Scholar
  39. 39.
    Fedorkow DM, Kalbfleisch RE. Total abdominal hysterectomy at abdominal sacrovaginopexy: a comparative study.Am J Obstet Gynecol 1993;169:641–643PubMedGoogle Scholar
  40. 40.
    Van Lindert ACM, Groenendijk AG, Scholten PC et al. Surgical support and suspension of genital prolapse, including preservation of the uterus, using Gore-tex soft tissue patch: a preliminary report.Eur J Obstet Gynecol Reprod Biol 1993;50:133–139PubMedCrossRefGoogle Scholar
  41. 41.
    Myomectomy Adhesion Study Group. An expanded polytetra-fluoroethylene barrier reduces post-myomectomy adhesion formation.Fertil Steril 1995;63:491–493Google Scholar
  42. 42.
    Baker KR, Beresford JM, Campbell C. Colposacropexy with Prolene mesh.Surg Gynecol Obstet 1990;171:51–54PubMedGoogle Scholar
  43. 43.
    Birnbaum SJ. Rational therapy for the prolapsed vagina.Am J Obstet Gynecol 1973;115:411–419PubMedGoogle Scholar
  44. 44.
    Valaitas SR, Stanton SL. Sacrocolpopexy: a retrospective study of a clinician’s experience.Br J Obstet Gynaecol 1994;101:518–522Google Scholar
  45. 45.
    Soichet S. Surgical correction of total genital prolapse with retention of sexual function.Obstet Gynecol 1970;36:69–75PubMedGoogle Scholar
  46. 46.
    Stanton SL. Silastic sling for urethral sphincter incompetence in women.Br J Obstet Gynaecol 1985;92:747–750PubMedGoogle Scholar
  47. 47.
    Friedman EA, Meltzer RM. Collagen mesh prosthesis for repair of endopelvic fascia defects.Am J Obstet Gynecol 1970;106:430–433PubMedGoogle Scholar
  48. 48.
    Horbach NS. Suburethral sling procedures. In Ostergard DR, Bent AE, eds. Urogynecology and urodynamics: theory and practice, 3rd edn. Baltimore: William and Wilkins, 1991;449–458Google Scholar
  49. 49.
    Handa VH, Jensen JK, Germain MM, Ostergard DR. Banked human fascia lata for the suburethral sling procedure: a preliminary report.Obstet Gynecol 1996;88:1045–1049PubMedCrossRefGoogle Scholar
  50. 50.
    Maloney JC, Dunton CJ, Smith K. Repair of vaginal vault prolapse with abdominal sacropexy.J Reprod Med 1990;34:6–10Google Scholar
  51. 51.
    Hendee AE, Berry CM. Abdominal sacropexy for vaginal vault prolapse.Clin Obstet Gynecol 1981;24:1217–1226PubMedCrossRefGoogle Scholar
  52. 52.
    Pelosi MA, Apuzzio J, Gowda V et al. Use of dermal graft in the surgical repair of vaginal vault prolapse.Obstet Gynecol 1980;55:385–388PubMedGoogle Scholar
  53. 53.
    Lansman HH. Posthysterectomy vault prolapse: sacral colpopexy with dura mater graft.Obstet Gynecol 1984;63:577–582PubMedGoogle Scholar
  54. 54.
    Fianu S. Absorbable polyglactin mesh for retropubic sling operations in female urinary stress incontinence.Gynecol Obstet Invest 1983;16:45–50PubMedGoogle Scholar
  55. 55.
    Dayton MT, Buchele BA, Shirazi SS et al. Use of an absorbable mesh to repair contaminated abdominal wall defects.Arch Surg 1986;121:954–960PubMedGoogle Scholar
  56. 56.
    Kavanah MT, Merrill FI, Devereux DF et al. New surgical approach to minimize radiation-associated small bowel injury in patients with pelvic malignancies requiring surgery and high dose irradiation.Cancer 1985;56:1300–1304PubMedCrossRefGoogle Scholar
  57. 57.
    Buchsbaum HJ, Christopherson W, Lifshitz J et al. Vicryl mesh in pelvic floor reconstruction.Arch Surg 1985;120:1389–1391PubMedGoogle Scholar
  58. 58.
    Patsner B, Mann WJ, Chalas E et al. Intestinal complication associated with use of the Dexon mesh sling in gynecologic oncology patients.Gynecol Oncol 1990;38:146–148PubMedCrossRefGoogle Scholar
  59. 59.
    Clarke-Pearson DL, Soper JT, Creasman T. Absorbable synthetic mesh (polyglactin 910) for the formation of a pelvic ‘lid’ after radical pelvic resection.Am J Obstet Gynecol 1988;158:159–161Google Scholar
  60. 60.
    Hoffman MS, Roberts WS, Lapolla SL et al. Use of Vicryl mesh in the reconstruction of the pelvic floor following exenteration.Gynecol Oncol 1989;35:170–171PubMedCrossRefGoogle Scholar
  61. 61.
    Abstracts of the World Congress of Gynecologic Endoscopy.J Am Assoc Gyneco Laparoscopists August 1995;2:(4)Google Scholar
  62. 62.
    Neel HB. Implants of Gore-tex: comparisons with Teflon-polytetrafluoroethylene carbon and porous polyethylene.Arch Otolaryngol 1983;109:427–433PubMedGoogle Scholar
  63. 63.
    Bryans FE. Marlex gauze hammock sling operation with Cooper’s ligament attachment in the management of recurrent urinary stress incontinence.Am J Obstet Gynecol 1979;133:292–294PubMedGoogle Scholar
  64. 64.
    Iosif CS. Sling operation for urinary incontinence.Acta Obstet Gynecol Scand 1985;64:187–190PubMedCrossRefGoogle Scholar
  65. 65.
    Creighton SM, Stanton SL. The surgical management of vaginal vault prolapse.Br J Obstet Gynaecol 1991;98:1150–1154PubMedGoogle Scholar
  66. 66.
    Nichols DH. Massive eversion of the vagina. In Nichols DH, ed. Gynecologic and obstetric surgery. St Louis: Mosby, 1993;456Google Scholar
  67. 67.
    Stoppa RE et al. The use of Dacron in the repair of hernias of the groin.Surg Clin North Am 1984;64:269–285PubMedGoogle Scholar
  68. 68.
    Brubaker L. Suburethal sling release.Obstet Gynecol 1995;86:686–688PubMedCrossRefGoogle Scholar
  69. 69.
    Nichols DH. The Mersilene mesh gauze-hammock for severe urinary stress incontinence.Obstet Gynecol 1973;41:88–93PubMedGoogle Scholar
  70. 70.
    Ogundipe A, Rosenzweig BA, Karram MM et al. Modified suburethral sling procedure for treatment of recurrent or severe stress urinary incontinence.Surg Gynecol Obstet 1992;175:173–175PubMedGoogle Scholar
  71. 71.
    Gunere H, Yildiz A, Erdem A et al. Surgical treatment of urinary stress incontinence by a suburethral sling procedure using a Mersilene mesh graft.Gynecol Obstet Invest 1994;37:52–55CrossRefGoogle Scholar
  72. 72.
    Yates MJ. An abdominal approach to the repair of posthysterectomy vaginal inversion.Br J Obstet Gynaecol 1975;82:817–89PubMedGoogle Scholar
  73. 73.
    Iosif CS. Abdominal sacral colpopexy with use of synthetic mesh.Acta Obstet Gynecol Scand 1993;72:214–217PubMedCrossRefGoogle Scholar
  74. 74.
    Randall CL, Nichols DH. Surgical treatment of vaginal eversion.Obstet Gynecol 1971;3:327–332Google Scholar
  75. 75.
    Williams TJ, TeLinde RW. The sling operation for urinary incontinence using Mersilene ribbon.Obstet Gynecol 1962;19:241–245PubMedGoogle Scholar
  76. 76.
    deVries MJ, van Dessel TH, Drogendijk AC et al. Short-term results and long-term patients’ appraisal of abdominal colposacropexy for treatment of genital and vaginal vault prolapse.Eur J Obstet Gynecol Reprod Biol 1995;59:35–38CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • C. B. Iglesia
    • 1
  • D. E. Fenner
    • 1
  • L. Brubaker
    • 1
  1. 1.Department of Obstetrics and GynecologyRush-Presbyterian-St. Luke’s Medical CenterChicagoUSA

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