Synthetic slings: Pros and cons

Plzak, Louis

doi:10.1007/s11934-002-0087-3

Cited by 22 publications

(12 citation statements)

References 12 publications

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“…Tissue responses to synthetic slings may be viewed as lying along a continuum with complete peripheral encapsulation at one extreme, and complete capsular integration at the other. Peripheral encapsulation with minimal fibrous in growth generally makes a sling easier to find and remove, should that be necessary [14]. In contrast, integration reduces the risk of mechanical irritation or injury, thereby reducing risk of sling erosion.…”

Section: Discussionmentioning

confidence: 99%

In vivo comparison of suburethral sling materials

2005

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In vivo tissue responses were compared for three commercially available polypropylene suburethral slings that differ markedly in fabric structure and in size of resulting interstices and pores. All three elicited the same basic inflammatory response; however, individual fabric structures produced distinct differences in tissue formation within each mesh. The presence of numerous, closely spaced, small diameter filaments prevented formation of extensive fibrous connective tissue within two slings (ObTape and IVS Tunneller mesh). The much larger diameter monofilament and open knit structure of the Monarc sling permitted the most extensive fibrous tissue integration. These differences may be of interest to physicians considering clinical use.

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Section: Discussionmentioning

confidence: 99%

In vivo comparison of suburethral sling materials

2005

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“…The pore size must be 1 75-100 m, because meshes with a pore size 1 100 m that allow fibrous tissue through mesh promote adhesion formation, while pores ! 75 m allow the predominant passage of histiocytes compared with fibrocytes, and adhesion of host tissue to the mesh of the sling is unstable [8][9][10][11][12] .…”

Section: Discussionmentioning

confidence: 99%

Time-Dependent Changes in Biomechanical Properties of Four Different Synthetic Materials in a Rabbit Model and the Importance in Respect to Sling Surgery

et al. 2008

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Aim: To examine the time-dependent biomechanical properties of four different implanted synthetic materials. Materials and Methods: 18 New Zealand rabbits were randomly categorized into three groups: group 1 to be evaluated at the 2nd week, group 2 at the 8th week, and group 3 at the 12th week. Before the implantation, baseline values were obtained. Each of the 2 × 5 cm sized materials of mersilene, prolene, ultrapro and vypro mesh were placed in the anterior abdominal fascia. The mesh materials were removed, tensile strength (N/mm²) and ultimate strain (%) were measured by tensinometry and surface area losses (cm²) were calculated. Results: Tensile strength values (mean ± SD) were 9.2 ± 1.5, 8.5 ± 1.2 for mersilene, 25.2 ± 7.3, 14.0 ± 2.9 for prolene, 2.2 ± 0.6, 12.5 ± 1.4 for ultrapro and 8.1 ± 1.6, 7.0 ± 1.8 for vypro at baseline and the 12th week. Ultimate strain values (mean ± SD) were 131.2 ± 46.1, 110.4 ± 98.6 for mersilene, 181.0 ± 26.4, 78.5 ± 14.4 for prolene, 91.5 ± 8.2, 89.6 ± 20.5 for ultrapro and 84.3 ± 8.9, 55.0 ± 13.2 for vypro at baseline and the 12th week. Surface areas (mean ± SD) were 8.87 ± 0.14, 9.38 ± 0.17, 8.4 ± 0.32 and 8.76 ± 0.16 for mersilene, prolene, ultrapro and vypro at the 12th week respectively. Conclusions: Although prolene mesh demonstrated a decrease in its tensile strength it still remains the highest at the 12th week. Considering the significant time-dependent increase in its tensile strength, ultrapro mesh should be studied in humans. A final decision on the preference of ultrapro mesh in sling surgery could be reached after such studies.

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“…The small-sized pores make the mesh vulnerable to infection because macrophages cannot penetrate it to clear the infection, necessitating mesh removal under such circumstances [18]. This type of mesh tissue tends to be encapsulated by a fibrous capsule with minimal growth of collagen into the mesh pores [17], which makes the mesh easy to remove upon the occurrence of infection [19]. The tape also has low elasticity (5%), which limits its adherence to surrounding tissues [2].…”

Section: Discussionmentioning

confidence: 99%

Mesh infection without erosion after ObTape sling insertion: a diagnostic challenge

Ismail

2007

Int Urogynecol J

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Infection is a recognised complication of using synthetic mesh tapes in continence surgery. It has only been reported alongside erosion after trans-obturator sling insertion for urodynamic stress incontinence. A 41-year-old patient developed mesh infection. This infection was diagnosed 16 months after insertion, when it became an abscess and discharged through her groin. The condition was not suspected earlier, despite having examination under anesthesia and repeat cystoscopy. The patient recovered upon removing the mesh and remains continent. This case documents the possible development of mesh infection without erosion. It highlights the importance of taking this possibility into consideration when dealing with patients after continence surgery and explores how it can be detected.

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Synthetic slings: Pros and cons

Cited by 22 publications

References 12 publications

In vivo comparison of suburethral sling materials

In vivo comparison of suburethral sling materials

Time-Dependent Changes in Biomechanical Properties of Four Different Synthetic Materials in a Rabbit Model and the Importance in Respect to Sling Surgery

Mesh infection without erosion after ObTape sling insertion: a diagnostic challenge

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