MRT diagnosing of the complications connected with urogenital prostheses
Grodno University Clinic, Grodno, Republic of Belarus
Vestnik VGMU. 2020;19(5):87-93.
Objectives. To analyze the data on the information content and the feasibility of control MRT studies in female patients who have undergone surgery to restore the position of their pelvic organs.
Material and methods. MRT data of 29 female patients who have undergone surgery for restoring the position of the bladder and urethra with the use of mesh prostheses served as the material for this study. The examination included a gynecological checkup, blood and urine tests, urofluometry, pelvic MRT, urethrocystoscopy.
Results. In 11 (37.9%) of 29 female patients, in the time from 1 to 2 years after surgical interventions, correcting cystocele and stress incontinence (SI) by means of synthetic mesh prostheses, with the first complaints of pain and gripes during urination, frequent urination, terminal hematuria (before surgery there were no complaints of this kind), MRT tomograms showed signs characteristic of complications: a substrate was revealed that led to the development of hyperactivity of the bladder, which served as the basis for surgical treatment. The remaining 18 (62.1%) patients also with the signs of bladder hyperactivity according to MRT data showed no manifestations of complications associated with genitourinary prostheses; there were no significant deviations from the norm when assessing the condition and position of the pelvic organs.
Conclusions. MRT made it possible to document the fact of the presence of complication and in 100% of cases to determine its type, which allowed in 37.9% of cases to change the method of management of patients from conservative treatment to the surgical one, as well as to choose an adequate surgical modality for correcting the developed complication.
Key words: magnetic resonance tomography, cystocele, stress incontinence, postoperative complications, diagnosing, synthetic prostheses.
1. Haylen BT, Freeman RM, Swift SE, Cosson M, Davila GW, Deprest J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Neurourol Urodyn. 2011 Jan;30(1):2-12. doi: http://dx.doi.org/10.1002/nau.21036
2. Divakova TS, Mitskevich EA. MESH-associated complications of pelvic floor surgery. V: Vitebckii gos med un-t; Deikalo VP, red. Dostizheniia fundamental'noi, klinicheskoi meditsiny i farmatsii: materialy 68-i nauch ses sotr un-ta, Vitebsk, 31 ianv – 1 fevr 2013 g. Vitebsk, RB; 2013. Р. 108-10. (In Russ.)
3. Nechiporenko AN, Nechiporenko NA, Egorova TIu, Iutcevich GV. Gynecare prolift surgical treatment of genital prolapse: complications and results. Reproduktiv Zdorov'e Belarusi. 2010;(1):43-9. (In Russ.)
4. Krasnopolskii VI, Popov AA, Abramian KN, Pushkar DIu, Gvozdev MIu, Malkhasian VA, i dr. Complications of MESH Vaginopexy: Results of a Multicenter Study. Urologiia. 2012;(1): 29-32. (In Russ.)
5. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth international consultation on incontinence recommendations of the international scientific committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213-40. doi: http://dx.doi.org/10.1002/nau.20870
6. Pushkar DIu, Kasian GR. Errors and complications in urogynecology. Moscow, RF: GEOTAR-Media; 2017. 377 р. (In Russ.)
7. Khatri G, Carmel ME, Bailey AA, Foreman MR, Brewington CC, Zimmern PE, et al. Postoperative imaging after surgical repair for pelvic floor dysfunction. Radiographics. 2016 Jul-Aug;36(4):1233-56. doi: http://dx.doi.org/10.1148/rg.2016150215
Information about authors:
Nechiporenko A.S. – roentgenologist, Grodno University Clinic.