Tolerance of synthetic tissues in touch with vaginal scars: review to the point of 287 cases.
(1999)
Journal - European journal of obstetrics, gynecology, and reproductive biology (IRELAND )
Abstract :
With an experience of 287 vaginal way operations using synthetic material, the authors make a review about the tolerance of the tissues. Three tissues were used (polytetrafluoroethylene, Dacron and Lyodura). The procedures are: Mouchel, big and small slings, Stamey and para vaginal refect procedures. At 30 months, the tolerance is 70% for Mouchel and 90% for sling procedures. The rejection rate with Dacron is globally 19.3% vs. 30.3% for Gore Tex . The authors describe materials' history, clinical symptoms and histopathologic signs of the intolerance. They think that the synthetic tissue tolerance is proportional to the exhibit surface and to the distance which separates it from the scar. The substratum of the intolerance process answers with two explanations: infection and foreign body reaction. Different theories are explained. Infection can be an ethiologic factor in early rejection. With rigid material, a small ulcer is formed and serves as a nidus for an ascending infection. Foreign material acts as an adjuvant by decreasing the number of bacteria necessary to produce an infection.The tissue reaction may be an immune response to Dacron, a delayed hypersensitivity reaction, or a graft vs. host antigen-antibody reaction. The ideal synthetic mesh material for pelvic surgery has yet to be developed.
| ISSN : | 0301-2115 |
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| Mesh Heading : | Biocompatible Materials Collagen Female Foreign-Body Reaction Humans Hypersensitivity, Delayed Polyethylene Terephthalates Polytetrafluoroethylene Prolapse Prostheses and Implants Prosthesis-Related Infections Vaginal Diseases |
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| Mesh Heading Relevant : | Cicatrix adverse effects surgery |
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Comparison of the Bologna and Ingelman-Sundberg procedures for stress incontinence associated with genital prolapse: prospective randomized study.
(1994)
Journal - European journal of obstetrics, gynecology, and reproductive biology (IRELAND )
Abstract :
It is difficult to make a choice among the many surgical procedures designed for the correction of stress urinary incontinence by the vaginal route because their results have not been correctly compared. The Bologna (B) operation uses two flaps from the anterior vaginal wall that are anchored to the abdominal wall; the Ingelman-Sundberg (IS) operation is a suburethral sling made from two transplants from the pubococcygeus muscle. A prospective randomized study has been carried out in order to compare these two procedures. A selection of cases has been based upon the presence of genuine or potential stress incontinence, genital prolapse and available tissues (anterior vaginal wall excess and palpable pubococcygeus muscles) for both procedures. No significant difference was noted for clinical results (91.7% and 93.7% of patients cured by the B and IS operations, respectively) or for transmission rate gain at 3 months and 1 year. Maximum urethral closing pressure was maintained in both treatment arms. No significant postoperative complication or persistent dysuria occurred. The Bologna procedure is best indicated in case of frank anterior vaginal excess, and the Ingelman-Sundberg procedure when strong anterior parts of pubococcygeus muscles are available. Both are excellent in the cure of stress incontinence associated with genital prolapse.
| ISSN : | 0301-2115 |
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| Mesh Heading : | Female Genital Diseases, Female Humans Prolapse Prospective Studies Surgical Flaps Urinary Incontinence, Stress Vagina methods etiology surgery |
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| Mesh Heading Relevant : | complications surgery |
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