Transvaginal Polytetrafluoroethylene Mesh Surgery for Pelvic Organ Prolapse: One-Year Safety and Efficacy Results.

OBJECTIVE: To evaluate the efficacy and safety of the polytetrafluoroethylene (PTFE) mesh by comparing conventionally used polypropylene (PP) mesh in tension-free vaginal mesh (TVM) surgery for pelvic organ prolapse (POP). METHODS: We conducted an observational cohort study of patients who underwent TVM using a PTFE or PP mesh. PTFE was used from June 2019 to May 2021, and PP mesh from January 2018 to May 2019. Outcomes included POP recurrence, perioperative complications, and patient satisfaction. Restricted mean survival time was used to analyze POP recurrence, comparing the time to recurrence between the two groups at 1year after TVM. RESULTS: Of 171 patients, 104 underwent PP mesh placement (PP group) and 67 underwent PTFE mesh placement (PTFE group). POP recurrence was observed in 10 and nine patients in the PP and PTFE groups, respectively. The mean time until the recurrence in the PTFE group was significantly shorter than that in the PP group (restricted mean survival time difference: -20.3days; 95% CI, -40.1 to -0.5; P = .044). Subgroup analysis revealed the meantime until recurrence was significantly shorter in the PTFE group for postoperative periods 3months or less, ages >70years, and POP stage ≥3. There were no intervention cases in either group and no significant differences in the perioperative complications. Patient satisfaction was greater in the PTFE group after 3months postoperatively. CONCLUSION: TVM surgery with a PTFE mesh is more prone to recurrence than that with a PP mesh, but with higher patient satisfaction. Within 3months of surgery, elderly patients and those with advanced-stage POP require care to prevent recurrence.

Lost Needle During Robot-Assisted Radical Prostatectomy: A Case Report and Literature Review.

Laparoscopic or robotic radical prostatectomy and partial nephrectomy require needle suturing and manipulation. Although uncommon, if a needle is lost during laparoscopy, locating and removing it is challenging. Here, we report a case of needle loss during robot-assisted laparoscopic radical prostatectomy (RARP). A 51-year-old patient with localized prostate cancer underwent RARP. After vesicourethral anastomosis using a 3-0 Barbed Suture with two threads connected in the tail, the two threads were held with a needle holder. One needle was lost during removal through a 12 mm trocar. A thorough laparoscopic examination of the abdominal cavity identified a needle attached to the abdominal wall, which was successfully removed. Needle loss is uncommon, but familiarity with handling and preventing such cases helps surgeons address further deterioration. Stepwise and intensive exploration should be performed to confirm the needle location.