Visualization of synthetic mesh utilizing optical coherence tomography.

Area of Science:

• Urogynecology
• Medical Imaging
• Biomaterials Science

Background:

• Pelvic organ prolapse (POP) repairs increasingly use synthetic mesh.
• Adverse events linked to mesh placement have raised safety concerns.
• Accurate postoperative assessment of mesh location and depth is crucial.

Purpose of the Study:

• To evaluate the utility of optical coherence tomography (OCT) for visualizing and measuring synthetic mesh post-POP repair.
• To determine if OCT can assess mesh location and depth within vaginal tissue microstructure.

Main Methods:

• Seventeen patients with prior mesh-augmented POP repairs (abdominal sacral colpopexy or vaginal repair) were included.
• Optical coherence tomography (OCT) was employed to image the vaginal wall.
• Mesh location and depth were measured and recorded if visualized.

Main Results:

• OCT successfully visualized mesh in 16 out of 17 patients.
• Mesh was consistently identified within the vaginal epithelial layer, irrespective of surgical approach.
• Mean mesh depths were recorded: 60.9 μm (ASC), 146.7 μm (anterior), and 125.7 μm (posterior).

Conclusions:

• Optical coherence tomography (OCT) is a viable tool for visualizing polypropylene mesh in the vaginal wall after POP repair.
• OCT can accurately determine mesh location and depth within the vaginal tissue microstructure.
• Findings suggest OCT can aid in assessing mesh placement and potentially identifying complications.