Microbial behaviour and response to polypropylene mesh
Research type
Research Study
Full title
Bacterial colonisation of polypropylene mesh and skin sutures types after incontinence surgery
IRAS ID
202766
Contact name
Douglas Tincello
Contact email
Duration of Study in the UK
1 years, 5 months, 24 days
Research summary
This study addresses the problem of post-operative tape exposure in the short term after surgery insertion of synthetic polypropylene midurethral tapes (MUT) for the surgical treatment of stress urinary incontinence in women. Post-operative MUT exposure or extrusion is uncommon, but has potentially significant implications for the patient. Simple re-covering of the exposed tape is rarely successful (33%) so most women require surgical excision of at least part of the mesh, after which over 50% will become incontinent again, then requiring further surgery. Mesh exposure can also cause chronic pain, dyspareunia, discharge and sinus formation.
It is clear that mesh complications are extremely important to the NHS and patients at the current time. Mesh exposure is a “live” issue, and carries potential long term sequelae. If the rate of mesh exposure could be minimised by simple measures, the health burden and cost implication of this complication would be reduced. There is sufficient indirect evidence to suggest that subclinical infection plays a role in the aetiology of short term mesh exposure and that the nature of the suture used to close the vaginal wound is implicated.
Our primary hypothesis is that multifilament sutures act as a “wick” to carry vaginal microorganisms into the wound site resulting in subclinical infection and suboptimal healing of the vaginal skin leading to short term mesh exposure. This proposal is a pilot study to examine the characteristics of both MUT tape material and the common sutures used to close the skin, to determine whether they have the ability to harbour micro-organisms which can later cause infection. The results of this small study will be used to support funding applications for a larger study involving more experimental work in the laboratory and a clinical trial.REC name
London - Hampstead Research Ethics Committee
REC reference
16/LO/1633
Date of REC Opinion
1 Sep 2016
REC opinion
Favourable Opinion