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Effect of mesh width on apical support after sacrocolpopexy
Sunil Balgobin1, Joseph L Fitzwater2, Donald D McIntire2
1Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9032, USA. Sunil.Balgobin@utsouthwestern.edu.
International Urogynecology Journal
|December 31, 2016
Summary
Wider polypropylene mesh (2-3 cm) offers better vaginal apical support and strength during sacrocolpopexy compared to narrower mesh (1 cm). This wider mesh also demonstrated less elongation and higher failure loads in cadaver studies.
Area of Science:
- Urogynecology
- Pelvic reconstructive surgery
- Biomaterials science
Background:
- Pelvic organ prolapse affects many women, often requiring surgical repair.
- Abdominal sacrocolpopexy is a common procedure for apical prolapse.
- The mechanical properties of polypropylene mesh are critical for successful surgical outcomes.
Purpose of the Study:
- To evaluate the impact of polypropylene mesh width on vaginal apical support.
- To assess mesh elongation and tensile strength in abdominal sacrocolpopexy.
- To determine optimal mesh dimensions for pelvic reconstructive surgery.
Main Methods:
- Abdominal sacrocolpopexy was simulated on ten cadavers using 1, 2, and 3 cm wide polypropylene mesh.
- Vaginal apex displacement and mesh stretch were measured under sequential 1-4 kg loads.
- Tensile strength and failure loads of single and double-layer mesh were tested.
Main Results:
- Wider mesh (2-3 cm) significantly improved vaginal apical support compared to 1 cm mesh (P < 0.0001).
- The 1 cm mesh exhibited greater elongation and ruptured in 40% of specimens.
- Failure loads increased with mesh width, with double-layer mesh showing higher strength.
Conclusions:
- Increasing polypropylene mesh width enhances vaginal apical support and mechanical integrity in sacrocolpopexy.
- Mesh widths of 2-3 cm provide adequate strength and support for pelvic reconstruction.
- Wider mesh is recommended to improve surgical outcomes and reduce failure rates.
