Assessment of collagen versus non collagen coated anterior vaginal mesh in pelvic reconstructive surgery: prospective study

Lo TS 1 , Cortes EFM 2 , Wu PY 3 , Tan YL 4 , Al-Kharabsheh A 5 , Pue LB 6

Affiliations 

  • 1 Department of Obstetrics and Gynecology, Keelung Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC; Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC. Electronic address: [email protected]
  • 2 Fellow of the Division of Urogynecology, Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, De La Salle University Medical Center, Dasmariñas Cavite, Philippines
  • 3 Department of Obstetrics and Gynecology, Keelung Medical Center, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC
  • 4 Fellow of the Division of Urogynecology, Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Kuching Specialist Hospital, Sarawak, Malaysia
  • 5 Fellow of the Division of Urogynecology, Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Obstetrics & Gynecology, King Abdullah University Hospital, University of Science & Technology, Irbid, Jordan
  • 6 Fellow of the Division of Urogynecology, Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
Eur J Obstet Gynecol Reprod Biol, 2016 Mar;198:138-144.
PMID: 26849040 DOI: 10.1016/j.ejogrb.2016.01.004

Abstract

OBJECTIVE: To evaluate the sonologic and clinical outcome of collagen coated (CC) versus non-collagen coated (NC) anterior vaginal mesh (AVM) for pelvic organ prolapse (POP) surgery.

STUDY DESIGN: The study is a prospective observational study which included 122 patients who had symptomatic POP stage III and IV. AvaultaPlus™ (collagen coated, CC group) was compared to Perigee™ (non collagen coated, NC group). Introital ultrasound morphology, measure of neovascularization by color Doppler and clinical outcomes were assessed. Student t test was used for comparison of pre- and post-operation continuous data (p value of <0.05).

RESULTS: A total of 110 (CC group=50, NC group=60) women completed the study. A woman in the CC group developed ureteral injury. Both groups had comparable morphologic and clinical outcomes however, the onset of changes in mesh thickness and neovascularization occurred earlier in the NC group (1 month) compared to the CC group (6 months to 1 year).

CONCLUSION: CC group was comparable to the NC group in terms of erosion rate, ultrasound and clinical assessment. Collagen coating may induce delayed inflammatory response however may also delay tissue integration. The onset of changes in mesh thickness and neovascularization may give us an insight toward utilization of collagen coated mesh for host-tissue integration.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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