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Three‐dimensional transperineal ultrasound for imaging mesh implants following sacrocolpopexy
Author(s) -
Eisenberg V. H.,
Steinberg M.,
Weiner Z.,
Alcalay M.,
ItskovitzEldor J.,
Schiff E.,
Lowenstein L.
Publication year - 2014
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.13303
Subject(s) - medicine , 3d ultrasound , ultrasound , coronal plane , surgical mesh , sagittal plane , anatomy , surgery , radiology , hernia
Objective To characterize, using three‐dimensional ( 3D ) transperineal ultrasound, the appearance, position and dimensions of mesh implants following minimally invasive abdominal sacrocolpopexy . Methods In women who underwent sacrocolpopexy, mesh was evaluated at rest and on maximal Valsalva, on all 3D orthogonal planes and rendered views. Mesh dimensions were obtained by 3D processing in the midsagittal and coronal planes (anterior, posterior and sacral arm) and were analyzed offline, the operator blinded to clinical data . Results Overall, 62 women, mean age 58.4 (range, 42–79) years were evaluated at a median of 9 (range, 1–26) months following surgery. The anterior arm of the mesh was caudal to the lowermost point of descent of the anterior compartment in 56 (90.3%) women, was equally positioned in five (8.1%) and was cranial in one. The posterior arm was caudal in 44 (71%) women, was equally positioned in 16 (25.8%) and was cranial in two (3.2%). The Y connection and the sacral arm of the mesh could not be adequately seen because of physical limitations of ultrasound (lower resolution at greater depth), large recurrent rectoceles, echogenic stools or folding of mesh remnants. Folding of the mesh was seen in 46 (74.2%) women, folding of the anterior arm in five (8.1%) and folding of the posterior arm in 23 (37.1%). Folding occurred caudally in 26 (41.9%) women, proximally in 11 (17.7%) and in both areas in nine (14.5%). There were no erosions . Conclusion Mesh visualization following minimally invasive abdominal sacrocolpopexy procedures using transperineal 3D /four‐dimensional ( 4D ) ultrasound is feasible. Studies are needed to evaluate the correlation between ultrasound measures and prolapse recurrence or mesh erosion. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd .