Summary:
Objective: The aim of this article is to review the incidence and prevalence of complications after
prosthetic surgery for POP (pelvic organ prolaps) and USI (urodynamic stress incontinence) and to
introduce diagnostic and therapeutic advice into clinical practice.
Design: Review article.
Settings: Gynecological and Obstetric Clinic, 1st LF UK and VFN, Prague.
Methods: Summary of complications, recent findings, opinions and specific diagnostic and therapeutic
recommendations with special focus to vaginal erosion, post-operative voiding difficulties, persisting
leakage of urine and de novo urgency.
Results: In the last decade the surgical treatment of female USI by prosthetic slings procedures has been
shown to be effective with high cure rate and low morbidity. Similary, prosthetic reconstruction of pelvic
organ prolapse through the different compartments has been introduced into clinical practice with good
anatomical and promising functional results. The article is structured to the different sections, describing
the epidemiology and management of complications after prosthetic slings procedures and after vaginal
prosthetic treatment of pelvic organ prolapse. The effect of various operations of pelvic floor and USI
using synthetic implants may differ, depending on the material of the implant used. Current
recommendation for the implants material: a light-weight, flexible polypropylene; Amid’s classification:
type 1, i.e macro-porous, monofilament material. The advantage of surgical treatment of pelvic floor
defect using implants comprises a low percentage of recurrence of the descensus.
Key words:
pelvic organ prolapse, urodynamic stress incontinence, surgical repair, synthetic implant
|