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Polyvinyldenfluorid (PVDF) versus Polypropylene (PP) mesh for sacrocolpopexy

Abstract: PD17-04
Sources of Funding: none

Introduction

The aim of this study was to compare a polymer mesh made of Polyvinyldenfluorid to polypropylene, the mesh material most commonly used in pelvic organ prolapse (POP) surgical repair, in terms of anatomical and functional results as well as safety, in patients who underwent sacrocolpopexy (SC)

Methods

This series included women who underwent SC for stages III or IV POP, according to the POP- Quantification (POP-Q) system, from 2005 to 2015, using either PP (Cousin Biotech Sacromesh®) or PVDF (DynaMesh®-PRS) mesh._x000D_ All women were preoperatively evaluated with history, physical examination and urodynamics. Urinary and sexual symptoms were assessed with the Urogenital Distress Inventory (UDI), the Incontinence Impact Questionnaire (IIQ-7) and the Female Sexual Function Index (FSFI) questionnaire. At the follow-up all patients were recalled and re-assessed with physical examination and the same questionnaires also used at baseline._x000D_ Patients’ satisfaction was recorded with the VAS score and the Patient Global Impression–Improvement (PGI-I) questionnaire._x000D_

Results

Between January and May 2016, 136 patients with at least 1 year follow-up were re-assessed: 73 who had polypropylene mesh POP repair (PP group) and 63 who had PVDF mesh repair (PVDF group). The only significant difference between the two groups was duration of follow-up: 94.9±21.7 months for the PP and 29.8±13.8 months for the PVDF group because the last one was marketed later. _x000D_ Postoperative anatomical correction rates (success: POP stages 0 or I), voiding and storage symptoms, urgency and stress incontinence, questionnaire scores and mesh erosion rates are reported in Table 1. Most outcomes were not significantly different between the two groups with the exception of storage symptoms, sexual symptoms and UDI-6 scores that were better in the PVDF group._x000D_ Subjective patient satisfaction was high in both groups with no significant differences between them_x000D_

Conclusions

Our results suggest that PVDF is at least as safe as polypropylene when used in POP repair. PVDF filaments have an excellent biocompatibility reducing adverse foreign body reactions such as granuloma formation, are associated with reduced bacterial colonization and maintain their tensile strength longer than polypropylene, that may explain the better results of PVDF in storage and sexual symptoms

Funding

none

Authors
Manuel Di Biase
Illiano Ester
Elena Sarti
Alessandro Zucchi
Raffaele Balsamo
Antonio Pastore
Elisabetta Costantini
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