Author:

Keywords:

1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine, 3215 Reproductive medicine, 4204 Midwifery

Abstract:

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 standard, polypropylene. 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.