Urogynecology Expert Forum
Connective Tissue Disease and use of Mesh
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Connective Tissue Disease and use of Mesh

Dear Dr., I hope you can help me make a decision.  I am scheduled for Robotic Sacralcolpopexy with polypropylene mesh for Apical Vag. Vault Prolapse at Mayo Clinic in May 2012. ( Previous POP repair failed in 1997).  The surgeon knows I have an autoimmune disease but doesn't see a problem using the synthetic mesh. I am worried because  in 2007 I had a succcessful rectopexy with resection for rectal prolapse,( POP not repaired at that time) in which the colorectal surgeon said she did not use mesh because it was contraindicated for people with connective tissue disease .   I have Sjogren's Syndrome with mild CKD (fluctuates between stage 2 and 3).  I have searched the internet for answers to this question of contraindication of mesh in connective tissue disease and have found little information.  Are there studies/research on this subject that will help me make an informed decision whether to have the surgery with mesh as planned or to seek an alternative material? Thanks.
Tags: contraindication????
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Thank you for your question.  Given your history with a prior failed repairI would agree with the use of synthetic mesh in a sacrocolpopexy providing the degree of prolapse is significant and you are having symptoms.  You are correct that is little in the literature regarding this issue and therefore any advice your receive will be based on the surgeons experience.  Alternatives to synthetic mesh for sacrocolpopexy have not proven very effective.  I have used synthetic mesh in a few patients with similar issues and have not had any issues.  I would suggest you express your concerns again to your surgeon and see what he or she's experience has been in theses situations.  

Good luck.  J. Kyle Mathews, MD   Plano Urogynecology
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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