Tailor-Made Mesh for Pelvic Organ Prolapses: Correlation between Patient’s Height and Mesh Size

Abstract

Tension-free vaginal mesh (TVM) surgery is a common and minimally invasive procedure for pelvic organ prolapses. Since commercial kits are not readily available in Japan, we have planned tailor-made mesh by information of each patient before every TVM surgery. The aim of this report is to inform methods to design mesh for individual patients with pelvic organ prolapses. We also investigated the correlations among mesh size and height, weight, and body mass index (BMI). Before the operation, we obtained a KUB (abdominal X-ray). Three factors were measured from this X-ray: the first was the distance between the bilateral ischial spine, the second was the distance between the obturator foramen, and the third was the length of the arcus tendineus fascia pelvis (ATFP). These three factors always should be considered for designing of mesh. The correlations among the bilateral ischial spine distance, obturator foramen distance, ATFP length, height, weight, and BMI were assessed using the Pearson correlation coefficient. Although these three factors described above are necessary to design a mesh for individual patients, the bilateral ischial spine and obturator foramen distance correlated with the height of the patient. On the other hand, since the length of ATFP differs in each patient and is not correlated with height, we should consider this length when we design the mesh. Well-designed, tailor-made mesh will probably fit each pelvic organ prolapsed patient very well.