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Journals / Türk Üroloji Dergisi/Turkish Journal of Urology / 2009 / Cilt: 35 - Sayı: 2

The use of "self-cut" polypropylene meshes in the management of stress urinary incontinence and pelvic organ prolapse

Stres tip idrar kaçırma ve pelvik organ prolapsı tedavisinde "kendi kesim"polipropilen meş kullanımı

Fikret Fatih ÜNOL
ALİ EGEMEN AVCI
Tolga ERGÖNENÇ
Pages
117–123
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Considering the conditions of our country, the use of these techniques may greatly decrease the cost of the procedure.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The use of synthetic meshes has gained popularity in the surgical treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP).
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Key Findings & Data:The aim of this study was to assess the efficacy and safety of “self-cut” prolene meshes in the management of SUI and POP.
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Conclusion & Impact:Considering the conditions of our country, the use of these techniques may greatly decrease the cost of the procedure.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Pelvis tabanı · Tedavi sonucu · Ameliyat sonrası dönem

Abstract

Objective: The use of synthetic meshes has gained popularity in the surgical treatment of stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The aim of this study was to assess the efficacy and safety of “self-cut” prolene meshes in the management of SUI and POP. Materials and methods: Eighty-nine patients underwent SUI and/or POP repair with the use of a 30x30-cm surgical polypropylene mesh (Gal-Mesh). Twenty-three patients (group 1; mean age 52 years) received TOT only, and 66 patients (group 2; mean age 51 years) underwent concomitant POP surgery (58 cystocele, 17 rectocele, 8 uterine prolapse). A prolene mesh strip of 1-cm width was placed as TOT. Anterior repair was performed either with a free, Y-type, or 4-arm mesh and posterior repair with a free mesh, combined with autologous vaginal flaps. Patients with uterine prolapse underwent anterior-posterior mesh repair using the transabdominal approach combined with sacrohysteropexy. The mean follow up was 12.8±6.9 months in group 1, and 13.5±7.1 months in group 2. Results: Dryness was achieved in 21 patients (91.3%) in group 1, and in 59 patients (89.4%) in group 2. De novo urge symptoms were seen in one patient (4.4%) and five patients (7.6%) in group 1 and 2, respectively. Bladder and rectal perforations occurred in two patients and one patient in group 2, respectively, and were repaired primarily. Anatomical cure was achieved in all the patients without any recurrence of POP. One patient in group 1 required mesh incision due to obstruction at day 25. Vaginal erosion was detected in two patients at 6 and 18 months following anterior repair using combined Y-type and 4-arm anterior meshes. None of the patients developed wound infection, pelvic abscess, or urethral erosion. Conclusion: Surgical management of SUI and POP with “self-cut” polypropylene meshes yields similar success and complications rates to those reported for industrial kits. Considering the conditions of our country, the use of these techniques may greatly decrease the cost of the procedure.

Özet

Amaç: Stres tip idrar kaçırma (STİK) ve pelvik organ prolapsı (POP) cerrahisinde sentetik meşlerin kullanımı gün geçtikçe artmaktadır. Bu çalışmada, “kendi kesim” cerrahi meşlerin STİK ve POP tedavisindeki etkinlik ve güvenilirliği değerlendirildi. Gereç ve yöntem: Çalışmaya, STİK ve POP nedeniyle 30x30 cm’lik cerrahi polipropilen meş (Gal-Mesh) kullanılarak tedavi edilen 89 hasta alındı. Yirmi üç hastada (grup 1; ort. yaş 52) sadece transobturator teyp (TOT), 66 hastada (grup 2; ort. yaş 51) TOT ile eşzamanlı POP (58 sistosel, 17 rektosel, 8 uterin prolapsı) onarımı uygulandı. Her iki grupta TOT olarak 1 cm eninde kesilen polipropilen meş bantı yerleştirildi. Ön onarımda serbest meş, “Y” tip veya “4 kollu” meş ile otolog vajen flepleri, arka onarımda serbest meş veya otolog vajen flepleri kullanıldı. Uterin prolapsus onarımında ise transbdominal yaklaşımla meşli ön-arka onarım ile birlikte sakrohisteropeksi uygulandı. Ortalama izlem süresi grup 1’de 12.8±6.9 ay, grup 2’de 13.5±7.1 ay idi. Bul¬gu¬lar: Grup 1’de 21 hastada (%91.3), grup 2’de 59 hastada (%89.4) tam kuruluk elde edildi. Grup 1’de bir hastada (%4.4), grup 2’de beş hastada (%7.6) “de-novo” sıkışma semptomları gözlendi. Grup 2’de iki hastada mesane, bir hastada rektum perforasyonu gelişti ve primer onarıldı. Hastaların hepsinde anatomik başarı sağlandı ve izlemde nüks POP görülmedi. Grup 1’de bir hastada ameliyat sonrası 25. günde tıkanıklık nedeniyle meşin kesilmesi gerekti. “4 kollu” ve “Y” meş ile kombine TOT+ön onarım yapılan iki hastada ameliyat sonrası 6 ve 18. aylarda vajinal erozyon saptandı. Hastaların hiçbirinde yara enfeksiyonu, pelvik apse veya üretral erozyon görülmedi. So¬nuç: “Kendi-kesim” polipropilen meş materyali ile STİK ve POP’nin cerrahi tedavisinde başarı ve komplikasyon oranları, ticari kitlerle bildirilen sonuçlardan farklı değildir. Ülkemiz koşullarında bu tekniklerin kullanımı işlem maliyetini önemli ölçüde azaltabilir.

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Cite This Article

ÜNOL, F. F., AVCI, A. E., ERGÖNENÇ, T. (2009). The use of "self-cut" polypropylene meshes in the management of stress urinary incontinence and pelvic organ prolapse. Türk Üroloji Dergisi/Turkish Journal of Urology, Cilt: 35 - Sayı: 2, 117–123. https://ajindex.com/articles/329054

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