Comparison of location of mesh placed transvaginally vs mesh placed abdominally at the time of sacrocolpopexy.
In: International Urogynecology Journal, Jg. 26 (2015), Heft 1, S. 79-83
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Zugriff:
Introduction and hypothesis: The location of mesh placed at the time of abdominal sacrocolpopexy (ASC) is hypothesized to be in the same location histologically as mesh placed via full-thickness vaginal dissection in a cadaver model. Methods: Ten fresh frozen cadavers underwent mesh placement via traditional ASC. In the same specimen, a transvaginal mesh (TVM) procedure was performed, attempting a full-thickness dissection. A block section was excised from each area including full thickness of the vagina and bladder with the intervening mesh. This was analyzed by a blinded pathologist. Results: All cadavers underwent successful placement of both transabdominal mesh and TVM. Of the abdominally placed meshes, 6 were located between the vagina and bladder, whereas 3 were situated within the vaginal wall, with an average depth of 0.30 mm. Five of the vaginal mesh pieces were placed between the bladder and vagina, and 4 within the vaginal wall at a depth of 0.25 mm. One specimen placed vaginally was 0.05 mm within the serosa of the bladder. One specimen could not be interpreted, despite multiple cuts. Conclusion: ASC and full-thickness vaginal dissection result in histologically similar locations. Dissection for ASC may only result in the correct plane between the bladder and vagina in approximately 60 % of cases. We achieved full-thickness dissection for the transvaginal approach in 50 % of the cases, with one small penetration into the bladder serosa. Using a full-thickness dissection technique for TVM may be one way of reducing mesh exposure rates in those seen with ASC. [ABSTRACT FROM AUTHOR]
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Comparison of location of mesh placed transvaginally vs mesh placed abdominally at the time of sacrocolpopexy.
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Autor/in / Beteiligte Person: | Noblett, Karen ; Brueseke, Taylor ; Lin, Fritz ; Rosenblatt, Peter |
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Zeitschrift: | International Urogynecology Journal, Jg. 26 (2015), Heft 1, S. 79-83 |
Veröffentlichung: | 2015 |
Medientyp: | academicJournal |
ISSN: | 0937-3462 (print) |
DOI: | 10.1007/s00192-014-2469-8 |
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