title: [Which prostheses to use in mesh sacrocolpopexy? Experimental and clinical study].
abstract: BACKGROUND
  Sacrocolpopexy is the standard surgical treatment of genital prolapse of the upper vaginal wall. Nowadays, the laparotomy approach is progressively supplanted by the laparoscopic procedure for the same anatomical results. About sacrocolpopexy, to date it still remains details of the technique, which differ with surgical teams maintaining controversy. Among them, the choice of the meshes certainly creates debate.
  
  
  OBJECTIVE
  To state the basic physicochemical principles which are necessary for surgeons to select the most suitable prosthetic material to obtain the most beneficial anatomic and functional outcomes for patients.
  
  
  METHODS
  The concepts of prosthetic biocompatibility, strength, shrinkage, deformation and elasticity are discussed. They are illustrated by experimental animal references and also human clinical references.
  
  
  RESULTS
  Macroporous polypropylene and polyester prostheses (pore size>1 mm) are properly integrated. Collagen prosthetic coating improves tissue integration. Absorbable and nonabsorbable ultralight prostheses expose patients to a high risk of recurrence. Multifilament polyester wide pore-side prostheses have less retraction and are more flexible than monofilament polypropylene prostheses.
  
  
  CONCLUSIONS
  The prosthetic cut-off weight below which the mesh does not offer any guarantee of strength is not precisely known. Moreover, the benefit of weight reduction is not proved. Currently, heavy weight multifilament polyester prostheses with wide pore size, more than 1mm, appear to be the most appropriate meshes for sacrocolpopexy without vaginal incision.
authors: Service de gynécologie-obstétrique et médecine de la reproduction, université de Grenoble-I Joseph-Fourier, CHU de Grenoble, CS 10217, 38043 Grenoble cedex 09, France. Electronic address: FSergent@chu-grenoble.fr.
authors: F
authors: F
authors: Sergent
authors: Équipe MM UMR 6270 INSA de Rouen, laboratoire polymères, biopolymères, surfaces, université de Rouen, avenue de l'Université, 76801 Saint-Étienne-du-Rouvray cedex, France.
authors: N
authors: N
authors: Desilles
authors: Laboratoire d'anatomie et cytologie pathologiques, université de Rouen, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors: J-C
authors: JC
authors: Sabourin
authors: UFR médecine-pharmacie, laboratoire de chirurgie expérimentale, université de Rouen, 22, boulevard Gambetta, 76183 Rouen cedex 1, France.
authors: J-P
authors: JP
authors: Marie
authors: Équipe MM UMR 6270 INSA de Rouen, laboratoire polymères, biopolymères, surfaces, université de Rouen, avenue de l'Université, 76801 Saint-Étienne-du-Rouvray cedex, France.
authors: C
authors: C
authors: Bunel
authors: Service de gynécologie-obstétrique et médecine de la reproduction, université de Rouen, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France.
authors: L
authors: L
authors: Marpeau
mesh_terms: D055598:Chemical Phenomena; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D011091:Polyesters; D011126:Polypropylenes; D019736:Prostheses and Implants; D013526:Surgical Mesh; D014596:Uterine Prolapse / Q000601:surgery
chemical_list: D011091:Polyesters; D011126:Polypropylenes
keywords: Polyester; Polypropylene; Polypropylène; Prolapse; Prolapsus; Promontofixation; Prosthesis; Prothèse; Sacrocolpopexy