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Human pathology v.69, 2017년, pp.46 - 54   SCI SCIE
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Pathological findings in explanted vaginal mesh

Li, Li (Department of Pathology, Shandong University, School of Medicine, Jinan, Shandong, 250012, PR China ) ; Wang, Xiaoyuan (Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, 85724, USA ) ; Park, Ji Young (Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, 85724, USA ) ; Chen, Hao (Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, 85724, USA ) ; Wang, Yiying (Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, 85724, USA ) ; Zheng, Wenxin (Department of Pathology, Shandong University, School of Medicine, Jinan, Shandong, 250012, PR China ) ;
  • 초록  

    Summary In light of the legal issues and the shortage of data on histopathological findings, we summarized our experience on how explanted vaginal mesh specimens were managed in a surgical pathology practice during the last 5 years. Clinical history and pathology reports were collected from 155 women undergoing transvaginal tape excision. The degree of chronic inflammation, fibrosis, foreign-body giant cell reactions, the number of capillary vessels and nerve fibers, and the presence or absence of adipose tissue were recorded. Among the 155 patients, 65 (41.9%) were active medicolegal cases, with a significant increase in recent years. The main medical indications for mesh excision were pelvic pain, mesh erosion, voiding dysfunction, genital organ prolapse, and vaginal bleeding. In most cases, mild to moderate chronic inflammation with a mild degree of foreign-body giant cell reaction and minimal to mild fibrosis were found in explanted mesh specimens. The specimens were well vascularized without any evidence of nerve abnormality. Patient age correlated negatively with vaginal pain ( P = .007) but positively with erosion ( P = .005). In addition, the presence of adipose tissue within the explanted mesh correlated significantly with pelvic pain ( P = .016). Overall, there was good tissue integration in all specimens. Considering the significant increase in the number of lawsuits in recent years, we recommend that all explanted vaginal mesh specimens be examined microscopically as well as grossly. A list of microscopic findings, including the presence or absence of adipose tissue, is suggested. Highlights Polypropylene transvaginal tape is useful for most cases of stress urinary incontinence. All explanted vaginal mesh specimens should be examined microscopically. A format for appropriate pathologic examination and reporting is provided.


  • 주제어

    Vaginal mesh .   Vaginal pain .   Stress urinary incontinence .   Mesh erosion .   Pathology .   Explant.  

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