OBJECTIVE: To characterize, using 3D transperineal ultrasound, the appearance, position, and dimensions of mesh implants following minimally invasive abdominal sacrocolpopexy.
METHODS: In women who underwent sacrocolpopexy, mesh was evaluated at rest and on maximal valsalva, on all 3D orthogonal planes and rendered views. Mesh dimensions were obtained by 3D processing in the midsagittal and coronal plane (anterior, posterior, sacral arm), and analyzed offline, blinded to clinical data.
RESULTS: Overall 62 women, mean age 58.4 years (range 42-79) were evaluated at 9 months mean (range 1-26) following surgery. The anterior arm of the mesh was caudal to the lowermost point of descent of the anterior compartment in 56 (90%), equally positioned in 5 (8.1%) and cranial in 1. The posterior arm was caudal in 44 (71%), equally positioned in 16 (25.8%) and cranial in 2 (3.2%). The Y connection and the sacral arm of the mesh could not be adequately seen due to ultrasound physics, due to large recurrent rectoceles, due to echogenic stools or from folding of mesh remnants. Folding of the mesh was seen in 46 (74.2%) women, of the anterior arm in 5 (8.1%) and of the posterior arm in 23 (37.1%). Folding occurred caudally in 26 (56.5%), proximally in 11 (23.9%) and in both areas in 9 (19.6%). There were no erosions.
CONCLUSION: Mesh visualization following minimally invasive abdominal sacrocolpopexy procedures using transperineal 3D/4D ultrasound is feasible. Studies are needed to evaluate the correlation between ultrasound measures and prolapse recurrence or mesh erosions.
Written by:
Eisenberg VH, Steinberg M, Weiner Z, Alcalay M, Itskovitz-Eldor J, Schiff E, Lowenstein L. Are you the author?
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer.
Reference: Ultrasound Obstet Gynecol. 2014 Jan 9. Epub ahead of print.
doi: 10.1002/uog.13303
PubMed Abstract
PMID: 24407819
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