Exploring the basic science of prolapse meshes.
Exploring the basic science of prolapse meshes.
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DOI：
10.1097/gco.0000000000000313
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发表时间：
2016-10
影响因子：
2.1
通讯作者：
Moalli PA
中科院分区：
文献类型：
--
作者：
Liang R;Knight K;Abramowitch S;Moalli PA
聚丙烯网片已广泛应用于盆腔器官脱垂的外科修复中。然而，与网眼相关的低但持续的并发症发生率，最常见的网眼暴露和疼痛，阻碍了它的使用。经阴道植入后的并发症更高，促使美国食品和药物管理局发布了两份公共卫生通知，警告与经阴道网片使用相关的并发症(PHN 2008和2011)，并将经阴道脱垂网片从II类设备升级为III类设备。虽然已经有许多研究确定网片并发症的发生率和处理以及对生活质量的影响，但很少有研究集中在机制上。在这篇综述中，我们总结了目前对网眼纺织特性和机械行为如何影响阴道结构和功能，以及局部免疫反应的了解。我们还讨论了网格属性如何随载荷的变化而变化。我们强调当前和未来研究的几个领域，以强调合作战略，包括基础科学研究，以改善患者的结果。
Polypropylene mesh has been widely used in the surgical repair of pelvic organ prolapse. However, low but persistent rates of complications related to mesh, most commonly mesh exposure and pain, have hampered its use. Complications are higher following transvaginal implantation prompting the Food and Drug Administration to release two public health notifications warning of complications associated with transvaginal mesh use (PHN 2008 and 2011) and to upclassify transvaginal prolapse meshes from Class II to Class III devices. Although there have been numerous studies to determine the incidence and management of mesh complications as well as impact on quality of life, few studies have focused on mechanisms. In this review, we summarize the current understanding of how mesh textile properties and mechanical behavior impact vaginal structure and function, as well as the local immune response. We also discuss how mesh properties change in response to loading. We highlight a few areas of current and future research to emphasize collaborative strategies that incorporate basic science research to improve patient outcomes.