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Congress: ECR24
Poster Number: C-21905
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-21905
Authorblock: K. Ahmad, R. Munyal; Nottingham/UK
Disclosures:
Kanzi Ahmad: Nothing to disclose
Rahul Munyal: Nothing to disclose
Keywords: Genital / Reproductive system female, MR, Education, Education and training
Learning objectives To demonstrate the normal MRI appearances of mesh devices used for pelvic organ prolapse repair To understand the MRI findings of common pelvic mesh repair complications
Read more Background Globally, approximately 40% of women are affected by pelvic organ prolapse – this percentage is only expected to rise with an aging population [1].The use of synthetic mesh for pelvic organ prolapse has increased in the past two to three decades. However, due to the increasing complications that arose following mesh repairs, they are now used with caution. A significant percentage of these patients continue to experience complications including mesh exposure/extrusion, mesh infection, adhesions, fistula formation and mesh failure [2].MRI...
Read more Findings and procedure details Rectopexy The mesh is secured to the rectal wall and suspended superiorly from the sacral promontory. In women, the mesh can also attached to the superior vagina for additional support [5]. (Figures 1-3) [fig 1]   [fig 2]   [fig 3] Rectopexy ComplicationsThe rectopexy mesh can cause secondary adhesions to the surrounding tissues and in more severe cases, fistulation. This example shows fibrotic changes at the insertion points as well as tethering of the rectum and vaginal vault. (Figure 4) [fig 4] Tension-free Vaginal Tape (TVT)TVT involves creating a sling...
Read more Conclusion As discussed, pelvic mesh repairs were previously a relatively common procedure. Due to the complications associated with such repairs and the complex subsequent treatment, there is now a ‘high vigilance restriction’ on their use in the UK, particularly in the treatment of stress incontinence [9].Nonetheless, as radiologists we need to be aware of the MRI findings to confidently diagnose these patients.
Read more References Wang, B. et al. (2022) ‘Global burden and trends of pelvic organ prolapse associated with aging women: An observational trend study from 1990 to 2019’, Frontiers in Public Health, 10. doi:10.3389/fpubh.2022.975829. Higgs, P.J., Chua, H. ‐L. and Smith, A.R.B. (2005) ‘Long Term Review of Laparoscopic Sacrocolpopexy’, BJOG: An International Journal of Obstetrics & Gynaecology, 112(8), pp. 1134–1138. doi:10.1111/j.1471-0528.2005.00646.x. Haouari, M.A. et al. (2023) ‘Complications of mesh sacrocolpopexy and rectopexy: Imaging  Review’, RadioGraphics, 43(2). doi:10.1148/rg.220137. National Institute for Health and Care Excellence and NICE...
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