Mesh contraction: myth or reality?
OBJECTIVE
Mesh implants are widely used in surgery for female pelvic organ prolapse. Mesh shrinkage is thought to be common and caused by immunological processes. In this longitudinal study, we examined mesh dimensions at 2 time points after implantation.


METHODS
We analyzed translabial 4-dimensional ultrasound (US) volume datasets of women seen 3-52 months after anterior compartment mesh. Datasets of first and last postoperative appointments were analyzed, with the operator blinded against all other data.


RESULTS
Forty women were assessed at least twice, comprising 59.6 woman-years. Thirty-seven of 40 (93%) were satisfied at their last appointment. Eighteen of 40 considered themselves cured, and 18 of 40 felt improved. Objective recurrence (cystocele stage 2 or greater) was seen in 16 of 40. Midsagittal mesh length increased significantly (35.8 vs 32.7; P = .006), and coronal mesh diameters increased nonsignificantly (37.4 vs 36.6 mm; P = .44).


CONCLUSIONS
Over an observation period of almost 60 woman-years, we found no evidence of mesh contraction.
Department of Obstetrics, Gynecology, and Neonatology, Sydney Medical School Nepean, University of Sydney, Penrith, NSW, Australia. hpdietz@bigpond.com
Hans Peter
HP
Dietz
Max
M
Erdmann
Ka Lai
KL
Shek
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D013526:Surgical Mesh / Q000009:adverse effects*