Bacterial Colonisation of Collagen-coated Polypropylene Vaginal Mesh: Are Additional Intraoperative Sterility Procedures Useful?

Overview

Journal Int Urogynecol J Pelvic Floor Dysfunct

Specialties Gynecology & Obstetrics
Urology

Date 2009 Sep 4

PMID 19727538

Citations 10

Authors

Astrid Vollebregt

Annet Troelstra

C Huub van der Vaart

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: The use of vaginally implanted polypropylene meshes in the treatment of prolapse is becoming increasingly popular. We set out to detect how often bacterial colonisation of the mesh occurs and if the intraoperative sterility procedures that are applied matter.

Methods: In 64 consecutive women, bacterial colonisation was compared between two intraoperative sterility procedures. Culture swabs of the core mesh were taken during surgery, and the mesh arms removed at the end of surgery were cultured separately.

Results: Sixty-seven implants were cultured. In 56 (83.6%) implants, a positive culture with vaginal bacteria was found with very low bacterial density (<10(3 )colony-forming units). No significant differences in bacterial species, density, clinical infection and erosion (two anterior and one posterior) were found between the two intraoperative sterility methods.

Conclusions: Colonisation of vaginally implanted mesh occurs frequently but in low bacterial densities, irrespective of the intraoperative sterility procedure used.

Citing Articles

The impact of bacterial contamination on the host response towards fully absorbable poly-4-hydroxybutyrate and nonabsorbable polypropylene pelvic floor implants.

Verhorstert K, Riool M, Bulten T, Guler Z, de Boer L, Roovers J Mater Today Bio. 2022; 15:100268.

PMID: 35517580 PMC: 9062440. DOI: 10.1016/j.mtbio.2022.100268.

In Vitro Bacterial Adhesion and Biofilm Formation on Fully Absorbable Poly-4-hydroxybutyrate and Nonabsorbable Polypropylene Pelvic Floor Implants.

Verhorstert K, Guler Z, de Boer L, Riool M, Roovers J, Zaat S ACS Appl Mater Interfaces. 2020; 12(48):53646-53653.

PMID: 33210919 PMC: 7716345. DOI: 10.1021/acsami.0c14668.

Is pain relief after vaginal mesh and/or sling removal durable long term?.

Jong K, Popat S, Christie A, Zimmern P Int Urogynecol J. 2017; 29(6):859-864.

PMID: 28695345 DOI: 10.1007/s00192-017-3413-5.

Prosthetic surgery versus native tissue repair of cystocele: literature review.

Vitale S, Lagana A, Gulino F, Tropea A, Tarda S Updates Surg. 2016; 68(4):325-329.

PMID: 26801794 DOI: 10.1007/s13304-015-0343-y.

New strategies to improve results of mesh surgeries for vaginal prolapses repair--an update.

Dias F, Dias P, Prudente A, Riccetto C Int Braz J Urol. 2015; 41(4):623-34.

PMID: 26401853 PMC: 4756989. DOI: 10.1590/S1677-5538.IBJU.2014.0163.

References

Maher C, Baessler K . Surgical management of anterior vaginal wall prolapse: an evidencebased literature review. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 17(2):195-201. DOI: 10.1007/s00192-005-1296-3. View

de Tayrac R, Devoldere G, Renaudie J, Villard P, Guilbaud O, Eglin G . Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre study. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 18(3):251-6. DOI: 10.1007/s00192-006-0135-5. View

Culligan P, Heit M, Blackwell L, Murphy M, Graham C, Snyder J . Bacterial colony counts during vaginal surgery. Infect Dis Obstet Gynecol. 2004; 11(3):161-5. PMC: 1852279. DOI: 10.1080/10647440300025515. View

Engelsman A, van der Mei H, Ploeg R, Busscher H . The phenomenon of infection with abdominal wall reconstruction. Biomaterials. 2007; 28(14):2314-27. DOI: 10.1016/j.biomaterials.2007.01.028. View

Bump R, Mattiasson A, Bo K, Brubaker L, DeLancey J, Klarskov P . The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996; 175(1):10-7. DOI: 10.1016/s0002-9378(96)70243-0. View

Athanasiou S, Matthaiou D, Falagas M . Vaginal mesh infection due to Bacteroides melaninogenicus: a case report of another emerging foreign body related infection. Scand J Infect Dis. 2006; 38(11-12):1108-10. DOI: 10.1080/00365540600664100. View

Deffieux X, de Tayrac R, Huel C, Bottero J, Gervaise A, Bonnet K . Vaginal mesh erosion after transvaginal repair of cystocele using Gynemesh or Gynemesh-Soft in 138 women: a comparative study. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 18(1):73-9. DOI: 10.1007/s0192-005-0041-2. View

Falagas M, Velakoulis S, Iavazzo C, Athanasiou S . Mesh-related infections after pelvic organ prolapse repair surgery. Eur J Obstet Gynecol Reprod Biol. 2007; 134(2):147-56. DOI: 10.1016/j.ejogrb.2007.02.024. View

Boulanger L, Boukerrou M, Rubod C, Collinet P, Fruchard A, Courcol R . Bacteriological analysis of meshes removed for complications after surgical management of urinary incontinence or pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19(6):827-31. DOI: 10.1007/s00192-007-0537-z. View

10.

Birch C . The use of prosthetics in pelvic reconstructive surgery. Best Pract Res Clin Obstet Gynaecol. 2005; 19(6):979-91. DOI: 10.1016/j.bpobgyn.2005.08.013. View

11.

Abdel-Fattah M, Ramsay I . Retrospective multicentre study of the new minimally invasive mesh repair devices for pelvic organ prolapse. BJOG. 2007; 115(1):22-30. DOI: 10.1111/j.1471-0528.2007.01558.x. View

12.

Schraffordt Koops S, Bisseling T, Heintz A, Vervest H . Prospective analysis of complications of tension-free vaginal tape from The Netherlands Tension-free Vaginal Tape study. Am J Obstet Gynecol. 2005; 193(1):45-52. DOI: 10.1016/j.ajog.2004.11.004. View

13.

Olsen A, Smith V, Bergstrom J, Colling J, Clark A . Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997; 89(4):501-6. DOI: 10.1016/S0029-7844(97)00058-6. View

14.

Sand P, Koduri S, Lobel R, Winkler H, Tomezsko J, Culligan P . Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol. 2001; 184(7):1357-62; discussion 1362-4. DOI: 10.1067/mob.2001.115118. View

15.

Shah D, Paul E, Amukele S, Eisenberg E, Badlani G . Broad based tension-free synthetic sling for stress urinary incontinence: 5-year outcome. J Urol. 2003; 170(3):849-51. DOI: 10.1097/01.ju.0000074712.09279.e3. View

16.

Cosson M . [Risk of infection and prostheses: time out or a red flag?]. J Gynecol Obstet Biol Reprod (Paris). 2004; 33(7):559-60. DOI: 10.1016/s0368-2315(04)96595-7. View