STUDY OF THE TISSUE REACTION OF THE VAGINAL WALL TO IMPLANTED POLYPROPYLENE PROSTHESES

Abstract

The aim of the research – to study the frequency of erosion of the vaginal mucosa and tissue response to polypropylene prostheses by morphometry in patients operated on for anterior genital prolapse. Materials and methods. Studied the frequency of mash-associated complications and tissue response during surgical correction of anterior prolapse by installing a polypropylene prosthesis in 206 patients at 3 and 12 months of the postoperative period. Tissue response was evaluated by biopsy of erosion of the vaginal mucosa with the capture of healthy tissues of the non-erosive vaginal mucosa to a depth of 2-3 mm, with excision of the polypropylene mesh and morphometric examination. Results. 3 months after surgery, 9.7 % of patients are diagnosed with erosion of the vaginal mucosa, which in 3.4 % are accompanied by migration of the polypropylene mesh into the vaginal cavity and its exposure. Against the background of conservative treatment for 12 months, relapse of erosion of the vaginal mucosa occurred in 5.3 % of women, which in 0.5 % was accompanied by migration of the prosthesis. A morphometric study of the unchanged vaginal wall after installing the polypropylene mesh showed that by 3 months after the operation, a full-fledged fibrous tissue forms, which changes little over time. In erosion of the vaginal mucosa, the reaction of vaginal wall tissues proceeds as a non-specific granulomatous inflammation in a phagocytic type. Conclusion. Despite the high biocompatibility of polypropylene material and its widespread use, further study of the tissue response to its implantation of polypropylene materials is necessary, possibly using immunohistochemical studies, which will clarify the pathogenesis of complications and possibly reduce their frequency.

Keywords

• эрозии слизистой влагалища
• mesh-ассоциированные осложнения
• воспаление
• полипропилен