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Nathan Goodyear

American Journal of Obstetrics & Gynecology Home Page - 0 views

www.ajog.org/...fulltext

"Vaginal mesh" immune system

shared by Nathan Goodyear on 31 Aug 18 - No Cached
  • M1 macrophages are characterized by the secretion of reactive oxygen species and proinflammatory cytokines and chemokines and can be identified via the cell surface marker CD86
  • M2 macrophages secrete growth factors and antiinflammatory immune modulators and can be identified by the cell surface marker CD206
  • an overzealous M2 response can also lead to excess tissue deposition and fibrosis
  • ...14 more annotations...
  • Studies of similar meshes that are used in hernia repair have demonstrated that all polypropylene meshes induce a prolonged inflammatory response at the site of implantation
  • the long-term presence of activated inflammatory cells, such as macrophages at the mesh tissue interface, can impact negatively the ability of the mesh to function as intended.
  • All M1 proinflammatory and M2 proremodeling cytokines and chemokines were increased in mesh explants as compared with nonmesh tissue (Table 3Table 3), which indicated a robust, active, and ongoing host response to polypropylene long after implantation
  • Comparison of the ratio of the M2 proremodeling cytokines (IL-10+IL-4) with the M1 proinflammatory cytokines (TNF-α+IL-12p70) revealed a decrease in mesh explants as compared with controls (P = .003), which indicated a shift towards a proinflammatory profile.
  • Mesh explants contained a higher number of total cells/×200 field when compared with controls (682.46 ± 142.61 cells vs 441.63 ± 126.13 cells; P < .001) and a lower ratio of M2:M1 macrophages (0.260 ± 0.161 cells vs 1.772 ± 1.919; P = .001), which supported an ongoing proinflammatory response.
  • the host response was proportional to the amount of material in contact with the host
  • A persistent foreign body response was observed in mesh-tissue complexes that were excised from women who required surgical excision of mesh months to years after mesh implantation
  • The host response was characterized by a predominance of macrophages with an increase in both proinflammatory and proremodeling cytokines/chemokines along with increased tissue degradation, as evidenced by increased MMP-2 and -9
  • Mesh-tissue complexes removed for mesh exposure had increased pro–MMP-9 that indicated a proinflammatory and tissue destruction–type response
  • The presence of macrophages, elevated cytokines, chemokines, and MMPs in tissue-mesh complexes that were excised from patients with exposure or pain suggests that polypropylene mesh elicits an ongoing host inflammatory response
  • In the presence of a permanent foreign body, the implant is surrounded with a fibrotic capsule because it cannot be degraded
  • For hernia meshes, if the fibers are too close (<1 mm), the fibrotic response to neighboring fibers overlaps, or “bridges,” and results in “bridging fibrosis” or encapsulation of the mesh
  • Gynemesh PS has a highly unstable geometry when loaded that resulted in pore collapse and increasing stiffness of the product
  • mesh shrinkage (50-70%) has been described to occur after transvaginal insertion of prolapse meshes
  • Nathan Goodyear on 31 Aug 18
     
    Mesh and the abnormal immune response.
Nathan Goodyear

AUGS : AUGS and ACOG Committee Opinion: The Use of Vaginal Mesh for Pelvic Organ Prolap... - 0 views

www.augs.org/fid=819

mesh erosion complication POP

shared by Nathan Goodyear on 07 Aug 16 - No Cached
  • 7% to 20%
  • mesh erosion was the most common complication, occurring in 5–19% of vaginal repairs using mesh
  • overall rate of mesh exposure was 18.8%
  • Nathan Goodyear on 07 Aug 16
     
    good review of data on complications of vaginal mesh surgery.  The rate of erosion found to be up to 20% in multiple studies.
Nathan Goodyear

Mesh implants: An overview of crucial mesh parameters - 0 views

www.wjgnet.com/...226.htm

vaginal mesh

shared by Nathan Goodyear on 07 Sep 18 - No Cached
  • Nathan Goodyear on 07 Sep 18
     
    vaginal mesh
Nathan Goodyear

Histological Inflammatory Response to Transvaginal Polypropylene Mesh for Pelvic Recons... - 0 views

www.researchgate.net/..._Pelvic_Reconstructive_Surgery

vaginal mesh mesh

shared by Nathan Goodyear on 07 Sep 18 - No Cached
  • Nathan Goodyear on 07 Sep 18
     
    vaginal mesh elicits chronic foreign body reaction
Nathan Goodyear

Inflammatory Reaction as Determinant of Foreign Body Reaction Is an Early and Susceptib... - 0 views

www.hindawi.com/...510807

vaginal mesh mesh inflammation

shared by Nathan Goodyear on 07 Sep 18 - No Cached
  • Nathan Goodyear on 07 Sep 18
     
    vaginal mesh
Nathan Goodyear

Exploring the basic science of prolapse meshes - 0 views

www.ncbi.nlm.nih.gov/...PMC5161092

vaginal mesh mesh immune system M1 M2 macrophages

shared by Nathan Goodyear on 24 Jan 19 - No Cached
  • Nathan Goodyear on 24 Jan 19
     
    Mesh implantation, here in the vaginal area, increases both M1 and M2 maturation migration. M1 increases pro-inflammatory signaling and processes and M2 promotes remodeling/healing... Both increase, but M1 increases more than M2 proportionally. M2 can increase the bridge scaring that can occur as well as the potential for immune suppression and autoimmune/cancer implications
Nathan Goodyear

Pathological findings in explanted vaginal mesh - ScienceDirect - 0 views

www.sciencedirect.com/...S0046817717303490

vaginal mesh inflammation

shared by Nathan Goodyear on 07 Sep 18 - No Cached
  • Nathan Goodyear on 07 Sep 18
     
    vaginal mesh and chronic inflammation
Nathan Goodyear

http://ec.europa.eu/health/scientific_committees/emerging/docs/surgical_co_harris3.pdf - 0 views

ec.europa.eu/...surgical_co_harris3.pdf

vaginal mesh mesh inflammation

shared by Nathan Goodyear on 07 Sep 18 - No Cached
  • Nathan Goodyear on 07 Sep 18
     
    vaginal mesh and inflammation
Nathan Goodyear

Transvaginal repair of genital prolapse: preliminary results of a new tension-free vagi... - 0 views

www.ncbi.nlm.nih.gov/...17131170

mesh prolift erosion

shared by Nathan Goodyear on 18 Aug 16 - No Cached
  • Mesh exposure occurred in five patients (4.7%)
  • Nathan Goodyear on 18 Aug 16
     
    mesh erosion rate of 4.7%.
Nathan Goodyear

Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the C... - 0 views

www.ncbi.nlm.nih.gov/...PMC4418012

mesh erosion complication POP prolapse pelvic organ prolapse

shared by Nathan Goodyear on 07 Aug 16 - No Cached
  • Nathan Goodyear on 07 Aug 16
     
    nice review of complications associated with vaginal mesh POP surgery.  The exposure rate was quoted at up to 10% by the review, but one study found the erosion rate to be 18% in slings, a much less complicated surgery compared to POP surgery.
Nathan Goodyear

Fulltext | Transvaginal mesh procedures for prolapse, analyzing its outcome rates and c... - 0 views

www.hoajonline.com/...4

mesh POP SUI complication erosion

shared by Nathan Goodyear on 07 Aug 16 - No Cached
  • Nathan Goodyear on 07 Aug 16
     
    erosion/extrusion rate of vaginal mesh placement is up to 17.3% in study.
Nathan Goodyear

Prospective clinical assessment of the transvaginal mesh technique for treatment of pel... - 0 views

www.ncbi.nlm.nih.gov/...22453786

mesh erosion complication POP

shared by Nathan Goodyear on 07 Aug 16 - No Cached
  • Nathan Goodyear on 07 Aug 16
     
    only abstract available here, but vaginal mesh exposure was found in 18.8% in 5 year prospective study of 95 women.
Nathan Goodyear

http://www.ics.org/Abstracts/Publish/105/000763.pdf - 0 views

www.ics.org/...000763.pdf

mesh POP SUI sling erosion complication

shared by Nathan Goodyear on 07 Aug 16 - No Cached
  • Nathan Goodyear on 07 Aug 16
     
    vaginal mesh erosion rates found to vary from 0.3% to 23% in 5 year study.
Nathan Goodyear

New considerations in the use of vaginal mesh for prolapse repair. - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...19423069

mesh complication erosion POP

shared by Nathan Goodyear on 07 Aug 16 - No Cached
  • Nathan Goodyear on 07 Aug 16
     
    only abstract available here, but vaginal erosion rate found to be 7-20%.
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