title: [Tolerance of synthetic tissues and vaginal surgery. Report of 287 cases].
abstract: OBJECTIVE
  In this presentation, we attract attention to the disadvantage of using synthetic material in functional surgery of prolapse and urinary incontinence.
  
  
  METHODS
  Two hundred eighty seven vaginal operations using synthetic material (Gore Tex, Dacron and Lyodura) were followed. The operations were: Mouchel procedure (127 cases), small slings (118 cases), large slings (11 cases), Stamey procedure (8 cases) and patch for paravaginal repair (23 cases). These operations were performed from 01/01/89 to 31/12/95.
  
  
  RESULTS
  Mean follow-up at study end was 49 months. The intolerance phenomenon, leading to rejection, occurred between 1 and 72 months. The Mouchel procedure gave a rejection rate of 28.3% versus 9.3% for the slings (p < 0.001). Dacron was better tolerated (rejection rate at 19.3%) than Gore tex (rejection rate at 30.2%), p < 0.05.
  
  
  CONCLUSIONS
  The substratum of the intolerance process would have two explanations (infection and foreign body reaction) for the early and late rejections. We suggest that the synthetic tissue tolerance is proportional to the exposed surface and to the distance which separates it from the vaginal scar. The ideal synthetic mesh material for pelvic surgery has yet to be developed.
authors.affiliation: Service de Gynécologie-Obstétrique, CH Dunkerque, Saint-Pol-sur-Mer.
authors.forename: P
authors.initials: P
authors.lastname: Debodinance
authors.forename: M
authors.initials: M
authors.lastname: Cosson
authors.forename: G
authors.initials: G
authors.lastname: Burlet
authors.forename: J B
authors.initials: JB
authors.lastname: Engrand
authors.forename: P
authors.initials: P
authors.lastname: Delporte
authors.forename: M
authors.initials: M
authors.lastname: Boulogne
authors.forename: D
authors.initials: D
authors.lastname: Querleu
authors.forename: G
authors.initials: G
authors.lastname: Crépin
mesh_terms: D003094:Collagen; D005260:Female; D006084:Graft Rejection; D006801:Humans; D008422:Materials Testing; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D014549:Urinary Incontinence / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery*
chemical_list: C032281:Lyodura; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D003094:Collagen