title: Visualization of synthetic mesh utilizing optical coherence tomography.
abstract: OBJECTIVE
  Owing to the recent upsurge in adverse events reported after mesh-augmented pelvic organ prolapse (POP) repairs, our aim was to determine whether the location and depth of synthetic mesh can be measured postoperatively within the vaginal tissue microstructure using optical coherence tomography (OCT).
  
  
  METHODS
  Seventeen patients with prior mesh-augmented repairs were recruited for participation. Patients were included if they had undergone an abdominal sacral colpopexy (ASC) or vaginal repair with mesh. Exclusion criteria were a postoperative period of <6 months, or the finding of mesh exposure on examination. OCT was used to image the vaginal wall at various POP-Q sites. If mesh was visualized, its location and depth was calculated and recorded.
  
  
  RESULTS
  Ten patients underwent ASC and 7 patients had 8 transvaginal mesh repairs. Mesh was visualized in 16 of the 17 patients using OCT. In all ASC patients, mesh was imaged centrally at the posterior apex. In patients with transvaginal mesh in the anterior and/or posterior compartments, the mesh was visualized directly anterior and/or posterior to the apex respectively. Mean depth of the mesh in the ASC, anterior, and posterior groups was 60.9, 146.7, and 125.7 μm respectively. Mesh was visualized within the vaginal epithelial layer in all 16 patients despite the route of placement.
  
  
  CONCLUSIONS
  In this pilot study we found that OCT can be used to visualize polypropylene mesh within the vaginal wall following mesh-augmented prolapse repair. Regardless of abdominal versus vaginal placement, the mesh was identified within the vaginal epithelial layer.
authors: Division of Female Pelvic Medicine and Reconstructive Surgery, North Shore University Hospital/Long Island Jewish, Manhasset, NY, USA, dshalom@nshs.edu.
authors: Dara F
authors: DF
authors: Shalom
authors: Katy J
authors: KJ
authors: Ledford
authors: Anwaar
authors: A
authors: Qadir
authors: Lawrence R
authors: LR
authors: Lind
authors: Harvey A
authors: HA
authors: Winkler
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D013526:Surgical Mesh / Q000009:adverse effects; D041623:Tomography, Optical Coherence
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