The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives.
The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives.
复制标题
DOI：
10.1002/jbm.b.34432
复制
发表时间：
2019-06
期刊：
影响因子：
--
通讯作者：
E. Mancuso;C. Downey;E. Doxford-Hook;M. Bryant;P. Culmer
中科院分区：
文献类型：
--
作者：
E. Mancuso;C. Downey;E. Doxford-Hook;M. Bryant;P. Culmer
盆腔器官脱垂（POP）是女性最常见的慢性疾病之一，影响着全世界数百万女性的生活质量。在过去的几十年里，已经开发了100多种外科手术来治疗POP。然而，保守策略的失败和有复发风险的患者数量增加了对进一步辅助治疗的需求。自引入以来，外科合成补片显著改变了POP修复，与传统方法相比，其解剖效果更好。虽然取得了重大进展，但在临床使用的补片中，没有一种补片适用于每一种手术。此外，由于急性和慢性感染、网状物收缩和组织侵蚀等并发症的风险，使用网状物的益处最近受到质疑。这项工作的目的是回顾POP手术的发展，分析当前的挑战，并详细说明与新网状系统设计相关的关键因素。从盆底解剖的描述开始，文章然后介绍了盆腔器官疾病的传统治疗方法。接下来，描述了合成网格的发展，深入了解其功能如何依赖于网格设计变量（即材料，结构和功能治疗）和手术应用。然后将这些与常见的网状相关并发症联系起来，并表明当前的研究旨在解决这些问题。
Pelvic organ prolapse (POP) is one of the most common chronic disorders in women, impacting the quality of life of millions of them worldwide. More than 100 surgical procedures have been developed over the decades to treat POP. However, the failure of conservative strategies and the number of patients with recurrence risk have increased the need for further adjuvant treatments. Since their introduction, surgical synthetic meshes have dramatically transformed POP repair showing superior anatomic outcomes in comparison to traditional approaches. Although significant progress has been attained, among the meshes in clinical use, there is no single mesh appropriate for every surgery. Furthermore, due to the risk of complications including acute and chronic infection, mesh shrinkage, and erosion of the tissue, the benefits of the use of meshes have recently been questioned. The aim of this work is to review the evolution of POP surgery, analyzing the current challenges, and detailing the key factors pertinent to the design of new mesh systems. Starting with a description of the pelvic floor anatomy, the article then presents the traditional treatments used in pelvic organ disorders. Next, the development of synthetic meshes is described with an insight into how their function is dependent on both mesh design variables (i.e., material, structure, and functional treatment) and surgical applications. These are then linked to common mesh-related complications, and an indication of current research aiming to address these issues.