TITLE:
Tailor-Made Mesh for Pelvic Organ Prolapses: Correlation between Patient’s Height and Mesh Size
AUTHORS:
Hideki Kobayashi, Yaburu Haneda, Satoru Kira, Takayuki Tsuchida, Isao Araki, Masayuki Takeda
KEYWORDS:
Pelvic Organ Prolapses; Surgery; Tension Free Vaginal Mesh; Tailor-Made Mesh; Mesh Size
JOURNAL NAME:
Open Journal of Urology,
Vol.3 No.2,
May
22,
2013
ABSTRACT: Tension-free vaginal
mesh (TVM) surgery is a common and minimally invasive procedure for pelvic
organ prolapses. Since
commercial kits are not readily available in Japan, we have planned tailor-made
mesh by information of each patient before every TVM surgery. The aim of this
report is to inform methods to design mesh for individual patients with pelvic
organ prolapses. We also
investigated the correlations among mesh size and height, weight, and body mass
index (BMI). Before the operation, we obtained a KUB (abdominal X-ray). Three
factors were measured from this X-ray: the first was the distance between the
bilateral ischial spine, the second was the distance between the obturator
foramen, and the third was the length of the arcus tendineus fascia pelvis
(ATFP). These three factors always should be considered for designing of mesh. The correlations among the bilateral
ischial spine distance, obturator foramen distance, ATFP length, height,
weight, and BMI were assessed using the Pearson correlation coefficient.
Although these three factors described above are necessary to design a mesh for
individual patients, the bilateral ischial spine and obturator foramen distance
correlated with the height of the patient. On the other hand, since the length
of ATFP differs in each patient and is not correlated with height, we should
consider this length when we design the mesh. Well-designed, tailor-made mesh will
probably fit each pelvic organ prolapsed patient very well.