Phosphorylcholine-Treated Pelvic Mesh May Improve Outcomes

January 23, 2013

Modifying the surface of pelvic mesh with phosphorylcholine (PC) may help reduce the incidence of mesh-related complications.

Modifying the surface of pelvic mesh with phosphorylcholine (PC) may help reduce the incidence of mesh-related complications, according to the results of a small pilot study.1
 
When used as a synthetic polymer-based coating, PC can enhance the biocompatibility of medical devices by reducing foreign body responses. This process has been used successfully in cardiac, ophthalmic, and other applications to reduce host inflammatory responses. To determine whether this process would improve the safety and effectiveness of polypropylene mesh grafts implanted to correct pelvic organ prolapse, surgeons from 5 sites in the United States collected data on patients whose pelvic organ prolapse was corrected surgically with Perigee IntePro Lite coated with PC. According to the authors, this is the first published study involving pelvic mesh treated with PC.1
 
In total, 40 women were enrolled in the study, with 32 women (80%) completing a minimum of 5 to 7 months of follow-up. The patients ranged in age from 36 to 78 years, and the mean patient age was 60 years. The body mass index (BMI) of patients ranged from 20 to 40, and the mean BMI was 28. Follow-up involved assessment of anatomical outcomes, symptomatic improvement, and complications, which included mesh exposure. Surgical success was defined as stage 1 or less using the Pelvic Organ Prolapse Quantification system or grade 1 or less using the Baden-Walker halfway system (Table).2

During the follow-up period, there were no cases of mesh exposure or mesh extrusion and no occurrences of granuloma formation. The procedure was associated with an anatomical success rate of 100% among the 32 patients who had an adequate follow-up period. In addition, modification of the mesh surface with PC resulted in no adverse events. Despite these encouraging results, the study authors caution that their results are not statistically significant because of the small study sample.

Pertinent Point:
- Pelvic mesh treated with phosphorylcholine shows promise in reducing complications related to pelvic organ prolapse repair.
 

References:

1. Chakrabarty A, Ganabathi K, Alexander JS, et al. Does pelvic mesh treated with phosphorylcholine improve outcomes? An early experience. Eur J Obstet Gynecol Reprod Biol. Dec 29, 2012. [Epub ahead of print].
2. Persu C, Chapple CR, Cauni V, et al. Pelvic organ prolapse Quantification System (POP-Q)-a new era in pelvic prolapse staging. J Med Life. 2011;4:75-81.