THE CLINICAL EFFICACY OF BIOLOGICMESH AND SYNTHETIC MESH FOR PELVIC FLOOR RECONSTRUCTIVE SURGERY
T. CAO, X. YANG, X. SUN, W.CHENG, J. WANG;
Ob&Gyn, Peking Univ. People's Hosp., Beijing,China.
Introduction:Pelvic organ prolapse (POP) is a major health concern that affectsnumbers of women, especially the elder female. Patients with severePOP usually have a combination of anatomic abnormalities, involvingthe anterior, posterior, and apical vagina and the uterus. Theincidence of women undergoing surgery becomes higher.  Over thepast decades, the prevalence of recurrent rate one year aftertraditional pelvic reconstructive surgery has been reported at about58%. Facing the high recurrence rates and hoping to reduce ratesof reoperation, surgeons have increasingly used mesh to correct POP,especially meshes made of prosthetic materials. We place mesh intothe vesicovaginal and rectovaginal spaces, restoring levels I and IIvaginal support. However, the complications associated with thesynthetic mesh materials (e.g. mesh erosion, vaginal infection,dyspareunia, chronic pain) seriously affect the women’s quality oflife (QOL). Thus, an ideal mesh material is neededurgently.
Objective: To compare clinical efficacy ofbiologic mesh and synthetic mesh in treatment of pelvic organprolapse(POP).
Methods: 96 patients with POP at more thanII of POP quantitation (POP-Q) staging system undergoing pelvicreconstructive surgery were selected and divided into two groups.Each group has 48 cases. One group was treated with Surgisis and theother was Avaulta. The perioperative, operative and postoperativedata were compared.
Results: The average of operationtime in Surgisis group was ( 126.4±39.8)min, which was significantlymore than the Avaulta. The average amount of bleeding volume inSurgisis [(130.5±98.4) ml] and Avaulta [(30.5±10.1) ml] hadsignificant difference. while the postoperative temperature, urinetube indwelling time, residual urine volume of the two groups had nodifference (P>0.05). At one-year follow up, the objectiverecurrence rate of Surgisis group is higher (24.96% vs 10.41%), butthe subjective recurrence rate is lower (6.25% vs 10.41%). Afteroperation, the quality of life in two groups was largely improved.Comparing the sexual quality of life, the score of Surgisis group washigher than that in Avaulta(P<0.05). There was no meshexposure in Surgisis group, while four patients had mesh erosion inAvaulta group. They all underwent surgery.
Conclusions:Comparing the synthetic mesh, biologic mesh in pelvic floorreconstructive surgery can improve the quality of life, reducing theoccurrence of complications, although it takes longer time and moreintraoperative blood loss in surgery.
References: 1. IntUrogynecol J. 2016, 12: 1-6 2. Female Pelvic Med Reconstr Surg, 2011,17: 174-179