Falagas Matthew E, Velakoulis Stamatios, Iavazzo Christos, Athanasiou Stavros
Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.
Eur J Obstet Gynecol Reprod Biol. 2007 Oct;134(2):147-56. doi: 10.1016/j.ejogrb.2007.02.024. Epub 2007 Apr 24.
The use of vaginal meshes has been an advance in the surgical management of women with pelvic organ prolapse. We reviewed the literature to synthesize the evidence regarding the infectious complications related to this new type of foreign body. We searched PubMed, current contents, and references of initially identified relevant articles and extracted data regarding the incidence, clinical manifestation, and management of vaginal mesh-related infections. The incidence of mesh-related infections and erosion ranged from 0 to 8%, and 0 to 33%, respectively, in the published studies. Various factors influence the development of vaginal mesh-related infectious complications such as the kind of biomedical material (e.g. filament structure, pore size) of the mesh, the type of procedure, the preventive measures taken, and the age and underlying comorbidity of the treated women. Non-specific pelvic pain, persistent vaginal discharge or bleeding, dyspareunia, and urinary or faecal incontinence are the most common manifestation of vaginal mesh-related infection. Clinical examination may reveal induration of the vaginal incision, vaginal granulation tissue, draining sinus tracts, and prosthesis erosion or rejection. Various pathogens have been implicated, including Gram-positive and Gram-negative aerobic and anaerobic bacteria. The management of mesh-related infections in women who underwent pelvic organ reconstruction is combined surgical and medical treatment. Although the use of vaginal meshes has become a new effective method of pelvic organ prolapse surgery clinicians should be aware of the various post-operative complications, including mesh-related infections.
阴道网片的使用是盆腔器官脱垂女性外科治疗的一项进展。我们回顾了文献，以综合有关这种新型异物相关感染并发症的证据。我们检索了PubMed、当期目录以及最初确定的相关文章的参考文献，并提取了有关阴道网片相关感染的发生率、临床表现及处理的数据。在已发表的研究中，网片相关感染和侵蚀的发生率分别为0%至8%和0%至33%。多种因素会影响阴道网片相关感染并发症的发生，如网片的生物医学材料类型（如丝状结构、孔径）、手术类型、采取的预防措施以及接受治疗女性的年龄和基础合并症。非特异性盆腔疼痛、持续性阴道分泌物或出血、性交困难以及尿失禁或粪失禁是阴道网片相关感染最常见的表现。临床检查可能发现阴道切口硬结、阴道肉芽组织、引流窦道以及假体侵蚀或排斥。多种病原体都有涉及，包括革兰氏阳性和革兰氏阴性需氧菌及厌氧菌。接受盆腔器官重建的女性中网片相关感染的处理是手术和药物联合治疗。尽管阴道网片的使用已成为盆腔器官脱垂手术的一种新的有效方法，但临床医生应意识到各种术后并发症，包括网片相关感染。
