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Anterior-apical single-incision mesh surgery (SIMS): surgical and functional outcomes at 1 year

Lo TS, Tan YL, Cortes EF, Pue LB, Wu PY, Al-Kharabsheh A

J Minim Invasive Gynecol, 2015 Jan;22(1):50-6.

PMID: 25017520 DOI: 10.1016/j.jmig.2014.07.002

To study the surgical and functional outcomes of single-incision mesh surgery for treatment of advanced pelvic organ prolapse (POP).

Ultrasonography and clinical outcomes following surgical anti-incontinence procedures (Monarc vs Miniarc)

Lo TS, Tan YL, Wu PY, Cortes EF, Pue LB, Al-Kharabsheh A

Eur J Obstet Gynecol Reprod Biol, 2014 Nov;182:91-7.

PMID: 25265496 DOI: 10.1016/j.ejogrb.2014.09.015

To evaluate the ultrasound morphology and its clinical outcome among women who had undergone Miniarc™ vs Monarc™ in the treatment of stress urinary incontinence (SUI).

Assessment of collagen-coated anterior mesh through morphology and clinical outcomes in pelvic reconstructive surgery for pelvic organ prolapse

Lo TS, Tan YL, Khanuengkitkong S, Dass AK, Cortes EF, Wu PY

J Minim Invasive Gynecol, 2014 Sep-Oct;21(5):753-61.

PMID: 24607796 DOI: 10.1016/j.jmig.2014.02.013

STUDY OBJECTIVE: To assess the morphologic features of anterior armed transobturator collagen-coated polypropylene mesh and its clinical outcomes in pelvic reconstructive surgery to treat pelvic organ prolapse.
DESIGN: Evidence obtained from several timed series with intervention (Canadian Task Force classification II-3).
SETTING: Chang Gung Memorial Hospital, Taoyuan, Taiwan, China.
PATIENTS: Between April 2010 and October 2012, 70 patients underwent surgery to treat symptomatic pelvic organ prolapse, stage III/IV according to the POP-Q (Pelvic Organ Quantification System).
INTERVENTION: Anterior armed transobturator collagen-coated mesh.
MEASUREMENT AND MAIN RESULTS: Morphologic findings and clinical outcome were measured. Morphologic features were assessed via 2-dimensional introital ultrasonography and Doppler studies. Clinical outcome was measured via subjective and objective outcome. Objective outcome was assessed via the 9-point site-specific staging method of the International Continence Society Pelvic Organ Prolapse Quantification before the operation and at 1-year postoperative follow-up. Subjective outcome was based on 4 validated questionnaires: the 6-item UDI-6 (Urogenital Distress Inventory), the 7-item IIQ-7 (Incontinence Impact Questionnaire), the 6-item POPDI-6 (Pelvic Organ Prolapse Distress Inventory 6), and the 12-item PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire), at baseline and at 12 months after the operation. Data were obtained for 65 patients who underwent the combined surgery and were able to comply with follow-up for >1 year. Ultrasound studies reveal that mesh length tends to shorten and decrease in thickness over the 1-year follow-up. Vagina thickness also was reduced. Neovascularization through the mesh was observed in <8.5% of patients in the first month and at 1 year, and was evident in approximately 83%. The mesh exposure rate was 6.4%. The recorded objective cure was 90.8% (59 of 65 patients), and subjective cure was 89.2% (58 of 65 patients) at mean (SD) follow-up of 19.40 (10.98) months. At 2 years, UDI-6, IIQ-7, and POPDI-6 scores were all significantly decreased (p < .001), whereas the PISQ-12 score was significantly increased (p = .01).
CONCLUSIONS: Ultrasound features suggest that the degeneration of collagen barrier may be longer than expected and that integration of collagen-coated mesh could occur up to 1 year. A substantially good clinical outcome was noted.
KEYWORDS: Anterior vaginal mesh; Collagen-coated mesh; Morphology; Outcome; Pelvic organ prolapse

Influence of anterior vaginal mesh with concomitant mid-urethral sling surgery on stress urinary incontinence: clinical and sonographic outcome

Lo TS, Tan YL, Cortes EF, Lin YH, Wu PY, Pue LB

Aust N Z J Obstet Gynaecol, 2015 Dec;55(6):593-600.

PMID: 26299981 DOI: 10.1111/ajo.12397

To clinically and sonographically evaluate the influence of anterior vaginal mesh (AVM) surgery with concomitant mid-urethral sling surgery (MUS) for stress urinary incontinence (SUI).

Clinical outcomes of mesh exposure/extrusion: presentation, timing and management

Lo TS, Tan YL, Cortes EF, Wu PY, Pue LB, Al-Kharabsheh A

Aust N Z J Obstet Gynaecol, 2015 Jun;55(3):284-90.

PMID: 26044791 DOI: 10.1111/ajo.12340

The Food and Drug Administration has recently highlighted an increase in reported complications associated with the use of transvaginal mesh.

Association of urodynamics and lower urogenital tract nerve growth factor after synthetic vaginal mesh implantation on a rat model

Lo TS, Lin YH, Chu HC, Cortes EF, Pue LB, Tan YL, et al.

J Obstet Gynaecol Res, 2017 Jan;43(1):173-178.

PMID: 27762470 DOI: 10.1111/jog.13158

AIM: By investigating the association of urodynamics and urogenital nerve growth factor (NGF) levels in vaginal mesh surgery, we may be able to associate the likelihood of postoperative lower urinary tract symptoms developing as a result of synthetic mesh implanted for pelvic floor reconstructive surgery.

METHODS: Thirty-eight female Sprague-Dawley rats were divided into three groups: mesh, sham (no mesh), and control. Urodynamic study and NGF analysis of the urogenital tissues were done and results were compared among all groups. The urodynamic studies of the mesh and sham groups were further divided into the 4th and 10th days. A P-value

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