EXPERIENCE OF USING XENOPERICARDIAL SURGICAL MESH FOR CORRECTION OF ANTERAPICAL GENITAL PROLAPSE IN WOMEN

Abstract

Since the restriction on the introduction of mesh prostheses in pelvic floor surgery, there has been a need to perform effective and reliable surgical interventions using other implants for the repair of pelvic organ prolapse. The possibility of using xenopericardial plates in gynecological practice remains a significant issue and represents a medical area of current interest for research. The purpose of the study is to evaluate the effectiveness and safety of using xenogeneic biomaterial for the correction of anterior-apical POP in women. Materials and methods. The study was conducted on the basis of the gynecological department N 2 of the Clinical Hospital named after S.V. Belyaev. The design of the study is prospective, observational. The study included 10 postmenopausal women admitted for planned surgical treatment with anterior-apical POP. The average age of the patients was 62.0 ± 4.9 years. All patients underwent surgical treatment of anterior-apical POP according to the author's technique (patent application N 2024109896 dated April 11, 2024) using xenogeneic biological material of the KemPlas surgical universal xenopericardial mesh. The effectiveness and safety of the use of the author's technique were assessed 7 days, 1 month and 6 months after surgical treatment. The primary outcome is the presence of complications of surgical treatment (implant rejection), the secondary outcome is relapse of POP. Results. During follow-up for 6 months, relapse of POP was not found in any patient. Infectious complications occurred in 4 patients (40 %). Implant rejection occurred in 4 (70 %): after 1 month – in two women (20 %), after 3 months – in 4 (40 %), in 1 (10 %) woman – after 5 months. In 3 (30 %) women, the postoperative period passed without complications: no inflammatory reactions, migration, or implant rejection were detected. These patients were 58, 65 and 70 years old; two older patients received long-term local estrogen therapy. The patients had no sexual activity, no heavy physical labor, and had normal body weight. Conclusions. Thus, the use of xenogeneic biomaterial for the correction of anterior-apical pelvic organ prolapse in women has a high incidence of implant migration and rejection. Further studies of the effectiveness of the use of this biomaterial are possible only in patients with no provoking factors (sexual activity, obesity, heavy physical labor, etc.) and after adequate preoperative preparation with local estriol preparations.

Keywords

• пролапс тазовых органов
• ксеногенный биоматериал
• ксеноперикард
• передне-апикальный пролапс