Tape erosion – local process or general reaction of the organism. The erosion rate and localization of implanted polypropylene tape in female pelvis

Abstract

Objectives: Our study was aimed to reveal whether the tape rejection is associated with increase in serum C-reactive protein level and to assess if localization of implanted polypropylene tape predisposes to its rejection. Material and methods: Between January 2002 and June 2005, 780 women with SUI or pelvic organ prolapsed underwent retropubic sling procedure – IVS 02 (n=379) or transobturator suburethral tape - IVS 04 (n=283) or posterior IVS operation (n=118). IVS multifilament tape (Tyco Healthcare) was used in all surgeries. The same antibiotic prophylaxis and disinfected procedure were applied in all cases. Follow-up visits were performed 4-6 weeks after the operation and next were scheduled every 3 months during first year after surgery and every 6 months in the years to follow. Blood to CRP level analysis (ELISA method) was collected form all patients with mesh erosion without any concomitant inflammatory or immunologic diseases. Results: Until January 2006 we have observed 28 cases of tape rejection: 5 after posterior IVS operation, 14 after IVS 02 and 9 after IVS 04. The chi-square test revealed no statistically significant differences between these groups. Ten women with mesh rejection were completely asymptomatic, two had fever and abscessi. Also, four women had pyogenic discharge from the skin or the vagina. Ten women complained of dyspareunia, vaginal bleeding and irritating voiding. We have found CRP values normal in all cases beside woman with fever and abscesi two. Conclusions: The process of mesh erosion in most cases is limited to local cellular response. The tape rejection rate is not associated with the localization of the implant in female pelvis.