a Department of Urology , St. George Hospital , Kogarah , New South Wales , Australia.
b Department of Urology , U.T. Southwestern Medical Center , Dallas , TX , USA.
Expert Rev Med Devices. 2019 Jul;16(7):569-580. doi: 10.1080/17434440.2019.1626230. Epub 2019 Jun 11.
Stress urinary incontinence and pelvic organ prolapse are major quality of life conditions affecting millions of individuals. Transvaginal mesh materials have been proposed to supplant native tissue repairs. However, these materials have opened a new field, meshology, devoted to the management of mesh complications.
This review highlights some of the recent developments in this subspecialty which often requires a multidisciplinary approach. With better imaging, the preoperative assessment of mesh complications has been enhanced. Specialized centers with high volumes are best suited to handle these challenging patients who fear the many risks of mesh removal and the uncertainties of their clinical status after the removal procedure(s). However, despite a better classification system recommended by specialized societies, the multidimensional outcome of these repair procedures will require the adoption of outcome tools which can cover several domains such as urinary incontinence, pelvic pain, dyspareunia, bladder infections, to name a few.
The surgical approach to mesh removal is also evolving with some experts recommending complete removal while others prefer more selective excision. Finally, the long-term outcome of these mesh removal procedures is not yet fully known.
压力性尿失禁和盆腔器官脱垂是影响数百万人生活质量的主要疾病。经阴道网片材料已被提议用于替代固有组织修复。然而，这些材料开辟了一个新的领域，即网片学，致力于网片并发症的管理。
本综述强调了这一分支学科的一些最新进展，该学科通常需要多学科方法。随着更好的成像技术，网片并发症的术前评估得到了改善。具有高容量的专业中心最适合处理这些有顾虑的患者，他们担心网片移除的许多风险以及移除程序后临床状况的不确定性。然而，尽管专业协会推荐了更好的分类系统，这些修复程序的多维结果仍需要采用可以涵盖几个领域的结果工具，如尿失禁、盆腔疼痛、性交困难、膀胱感染等。
网片移除的手术方法也在不断发展，一些专家建议完全切除，而另一些专家则更喜欢更有选择性的切除。最后，这些网片移除程序的长期结果尚不完全清楚。
