International urogynecology journal vol:17 pages:197-197
IUGA edition:31 location:Athens, Greece date:2006
Objectives: The purpose of this study was to evaluate the
use of biomaterials and collagen coated materials
performing sacral colpopexy and compare them with the
Materials and methods: In consecutive series, 149 patients
underwent sacral colpopexy with one of the four study
materials: lightweight polypropylene (Gynemesh, Johnson & Johnson), cross-linked dermal collagen (Pelvicol, Bard),
small intestinal submucosa (SIS, Cook) or collagen coated
polypropylene (Pelvitex, Bard). Primary outcomes included
subjective cure, defined as absence of prolapse symptoms,
objective cure, defined as absence of vaginal prolapse ≥Stage II at any compartment and local mesh complications(erosion, infection, pain). Secondary outcomes included bowel, bladder and sexual function, and quality of life.
Results: Ninety-five percent of the patients were followed up for 24±16.9 months (range 3–115). The subjective cure
rate was significantly lower in the Pelvicol operated
patients. The objective cure rate was significantly lower
for patients operated with SIS. There were 6% local mesh
complications. The mesh erosion rate was 2.6% for the
Gynemesh group, 5% for the Pelvitex group, 2.1% for the
Pevicol group and 0% for the SIS group. There were 5.1%
partial mesh excisions in the Gynemesh group and 2.5% in
the Pelvitex group because of pain related to a folded mesh.
SIS was associated with 8.3% mesh infections successfully
treated with antibiotics and vaginal drainage in one patient.
Conclusion: Biological materials are associated with a
lower subjective and objective cure rate. Although biological materials have been introduced to avoid local side effects associated with synthetic non-absorbable meshes, local mesh complications may occur. Collagen mesh
coating does not decrease the rate of mesh complications
compared to uncoated polypropylene meshes.