Has anyone had a successful anterior wall repair with biological graft?

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I had a hysterectomy and sacrocolpopexy for prolapse nearly 2 years ago. Soon after prolapse recurred. Have stage 3 cystocele and 2 rectocele. I Have 2 surgical options.( Pessaries failed) option 1: traditional repair. Option 2: anterior wall repair with biological mesh/ graft. I can't find much information on biological mesh (plenty on the horrors of synthetic mesh)

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  • Posted

    Hello Rosabee. There have been more problems with biological mesh than synthetic mesh because the use of synthetic mesh is closely monitored and only registered urogynaecologists can use it in the UK now. Results are excellent and there are very few problems. I've read research on biological mesh and there have been a lot of problems. I'm sure if any ladies have experience of it they will be in touch.

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    • Posted

      Thanks. Research data on biological mesh is what I want. Can you cite your sources please? (I am puzzled however by your saying synthetic meshes have few problems in vaginal wall repair. There have been significant problems and it is no longer widely used.)

       

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    • Posted

      Are you in the U.K. Rosabee? I only ask because the use of mesh is more closely monitored than anywhere else such as USA and Canada and the mesh used is different to the mesh that caused all of the problems in the USA and Scotland among other countries. We have a restricted list of urogynaecologists who can perform prolapse surgery using mesh, I have worked with 2 of them and I have to say there haven't been any problems. I think if there were the Department of Health would stop it's use immediately, that's how strict they are. The information and research on biological mesh is widely available online, in fact I have just read some. The research was from the USA.

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    • Posted

      Yes, in uk. I am surprised you say there haven't been problems in UK. I know for a fact there have. And my urogynaecologist has stopped using it although he used it a lot in the past.

      Can you give me the title of the research into biological mesh you read? My searches show up very little. a Thank you.

       

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    • Posted

      I did say the mesh had changed from the days when there had been problems. Your urogynaecologist probably doesn't use it anymore because he isn't  be one of the few selected by the Department of Health to use it. Yes there were problems but not recently now there is restricted use.

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  • Posted

    Hi I have just had a prolapse repair using the tape to keep it in place. I also read about the problems with the tape but unfortunately not until after I had had it done. I'm in my 6th week now and not feeling too bad. It's not easy not doing much though I think that's getting me down the most.

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  • Posted

    I had repair for stage 3 and 4 rectocele and cystecele. They used a mesh made from pigs bladder called ACell.

    And they made a sling out of same material. I'm 6 months out. But so far no problem from mesh except my sling is a little to tight and it's preventing me from emptying completely. I'm in US.

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  • Posted

    I had a biological mesh for a rectocele and it was fine.  I was told it wasn't strong enough to hold up the bladder but that's just what my urogyn said.  I haven't read studies on it.

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  • Posted

    I had synthetic tape 15mths ago & am totally fine. My Urogynae fully explained the old mesh issues where there were problems. Some company was producing dodgy mesh back then. That mesh hasn't been used now for years. It's just the same story as dodgy breast implants and dodgy total hip joint replacement parts. We are just lucky ladies that our prolapses can be repaired using the approved tape now. I have previously heard of Dr's saying they don't use it anymore, but should be admitting that that is cause they aren't approved to use it. I'm totally sure I would way more approve of the surgical mesh going into my body compared to a piece of pig!! I believe the few percent failure rate now with mesh is completely on par with all other foreign things put into our bodies during various procedures. There is always going to be a few percent who will react to foreign stuff. My Urogynae showed me a mesh tape while explaining it all on 1st consult. I would only have it done by a Urogynae that has and does use it heaps & is highly experienced with its placement. I also want to say there is less failures of repairs where tape is used as it's a pretty good anchor, so long as you stick to the post-op recommendations of what you shouldn't do.

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    • Posted

      Hi Robyn

      Thanks for this info. Did you have the tape for an anterior vaginal wall repair? I haven't been offered synthetic. Was told it's not used anymore because of complications. Are you in the Uk?

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    • Posted

      It's lovely to read robyn that a urogynaecologist showed you the tape that he was going to use. I'm always heartened when I read that because you hear so many ladies say their urogynaecologist/consultant didn't explain things very well. You are right about certain consultants saying they don't use mesh because they aren't registered to do so of course. I have a list of urogynaecologists who are allowed to do so and it is limited now so that it's use can be closely regulated. Fortunately there are less failures because of the restrictions (some consultants were using it without the necessary training) and because the mesh is different which is what I tried to get over in my post. I'm so pleased you are doing well robyn x

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    • Posted

      No need to scare people off the biological mesh. There are a lot of very good things about that, too.  And in terms of the ick factor, I didn't find that to be a problem at all.  You aren't getting a fleshy pink bit of a pig.   The mesh is from pigs bladder but it is thin, white, sterilized, and mostly collagen.  It gets fully absorbed by your body in about 12 weeks and it promotes growth of your own tissue.  

      synthetic mesh and biological mesh both have their uses and advantages.  I had a biological mesh for my rectocele repair but I was told it isn't strong enough for anterior repairs (which I didn't need, but the doc mentioned it in passing).

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    • Posted

      Porcine has been used for years by surgeons performing hernia repair mainly on men. The porcine dissolves after 12 months when all the tissues will have formed around it. 
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    • Posted

      People ask on here for personal opinions so that's what I gave. I was trying to support surgical mesh more highly than what the original post currently thought about it. I firmly believe it's now fine AND firmly believe that it is currently the best support method when that is needed for anterior repair and stress incontinence. I know too many who stayed away from mesh & repair relied on their own tissues, to end up failing. I wonder how many failures there are where mesh was used compared to stitching. If mesh seems to be the best way to support bladder up in place, then I believe you go for it. Just maybe the repair will last a lot longer & not need doing again. There are scaremonger stories about every operation & always a few will fail too, but for me the mesh made perfect long term sense to have best possible support inside. I don't like the idea of biological because I feel it is just adding more tissue & relies on bodies ability to take it up. Whereas you put a mesh sling mid way up urethra and mostly that's gonna hold up what needs supporting into correct position (if done correctly too by Urogynae who is very experienced).

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    • Posted

      Hi. I think seeing and feeling the mesh sold the idea to me. Plus getting 100% confidence from him that he was vastly experienced in woman's issues down there & reputation from midwife friends helped. Lots of medical friends said that he would be there choice for anything down there, including my GP who is exactly my age. I watched some of his YouTube videos and his interviews on daytime TV about woman's issues of prolapses. He was on a drive to get more people comfortable with talking about prolapses and stress incontinence etc. so that woman don't feel badly about themselves & believe nobody else must have my problem. His 8yr old Daughter is on a fast track already to ending up in medicine & the video he was making 15mths ago involved her as the main person. She is very knowledgeable already & confident & loves what her Father is all about. I also was priveledged to be able to select a private Specialist of my choice after researching them, & I understand not everybody can.

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    • Posted

      Hi. Yes I did go for mesh for anterior prolapse & stress incontinence. I'm in New Zealand. As Matron & I suggested, your Urogynae should actually possibly just admit he doesn't offer it because he isn't allowed to use it. Plus he should be giving you the current info about how the mesh is now very successful as the dodgy stuff has not been used for years now once it was discovered that it was made badly & causing probs too often. If you like the idea of mesh, then ask to have a consult with a Urogynae who does use it all the time so that you get current info on it. Every procedure has a small failure rate but so long as it's only a few percent. No matter what you put into a very low percentage of people, they will reject it. There is no 100% guarantee on anything. My Urogynae said that at the recent Conference he had been to they decided that 50% of all woman who have given birth will have some level of problem down below, some won't ever go for surgery as in the belief that it's uncommon & not talked about, & of that 50% half will require surgery at some point if they have given birth to a baby over 9lbs.

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    • Posted

      I was told that chance of success i.e. Non - Recurrence of prolapse with traditional anterior repair ( buttress and fascia stitching ) is 60% and with biological mesh 70%. The consultant suggesting the biological mesh has been performing this operation for 4 years and has done aver 300 with 80 % success.  I am not put off by it being porcine, as it's closer to our natural bodies than prolene. This is why I am tending more towards this option. The strength comes from the scar tissue which forms over the graft. Interesting though that your doctor said it wasn't strong enough to support the bladder. I will ask about this, specifically.

      I will, however, look into the use of new synthetic mesh. I do wonder how much of what's on offer is driven by pharmaceutical companies pushing one product over another, and how quickly new products are licensed and  as suggested which doctors are licensed for what. I wonder how much is about what actually best suits the patient, especially when the NHS is in crisis.

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