Number №1, 2020 - page 130-135

Surgical correction of pelvic organ prolapse: rationale for the use of synthetic implants DOI: 10.29188/2222-8543-2020-12-1-130-135

Nechiporenko A.N., Mihal'chuk E.Ch., Nechiporenko E.A.
Information about authors:
  • Nechiporenko A.N. – PhD., Associate Professor, Department of Surgical Diseases II, Educational Institution «Grodno State Medical University», ORCID 0000-0002-3304-6393
  • Mikhalchuk E.Ch. – PhD., Associate Professor, Department of Histology, Cytology and Embryology, Educational Institution «Grodno State Medical University»
  • Nechiporenko N.A.– Dr. Sc., Professor, Department of Surgical Diseases II, Educational Institution «Grodno State Medical University»

Introduction. Pelvic organ prolapse (VET)in the form ofcystocele and rectocele occursin 57-78% ofwomen aged 50 years and older. One of the methods of treatment is surgical intervention using synthetic mesh implants. The method of vaginal extraperitoneal colpopexy with synthetic implants in the surgical treatment of pelvic organ prolapse using original systems, which allows strengthening or replacing insolvent ligaments and fascia of the pelvic floor, is pathogenetically substantiated. There is very little work devoted to studying the effect of the polypropylene network on the vaginal tissue in women after mesh implant implantation in order to correct pelvic organ prolapse.

Patients and methods. A complex of histological and histochemical methods for the study of biopsy specimens of the anterior and posterior walls was performed vaginas in 31 women operated on for VET by the method of vaginal extraperitoneal anterior or posteriorcolpopexy with syntheticimplants from the polypropylene surgical mesh ESFIL «white-blue» (Linteks, Russia). 11 patients, 4-6 months after surgical correction of VET, due to the developed complications, were re-operated; them underwent a histological examination of removed vaginal tissues with implant fragments.

Results. It was shown that women with VET have changes in the structure of collagen fibers, their density in the walls of the vagina during VET is not the same, in some places their number is high, in others reduced, foci of collagen fiber breakdown and pronounced lymphocytic infiltration are noted. In these places, the content of glycoproteins is reduced. 4-6 months after the operation, mature and well-vascularized dense connective tissue is formed around and between the threads of the mesh implant due to active collagen formation.

Conclusions. Women with pelvic organ prolapse have changes in the content of collagen fibers, glycoproteins, sulfomucins and sialomucins, which can cause a weakening of the biomechanical strength of connective tissue. The synthetic polypropylene implant from the surgical mesh implanted into the paravaginal space does not cause irreversible changes in the surrounding tissues and is not rejected. The implant allows the formation of powerful neofascia, creating a solid support for the pelvic organs, providing them with a physiological position.

Conflict of interest. The authors declare no conflict of interest.

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cystocele, rectocele, synthetic implants, histological and histochemical studies

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