Does anchoring vaginal mesh increase the potential for correcting stress incontinence?

BACKGROUND: This study aims to explore the feasibility of anchoring a four-arm transvaginal mesh (TVM) to the mid-urethra to correct an anterior compartment POP-Quantification stage II-III (Q II-III) and concomitant genuine SUI. METHODS: We analysed clinical data from 248 patients with stage II-III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2008 and June 2010. One hundred and twenty-four women treated with anterior colporrhaphy and 62 patients implanted with a conventional permanent TVM were selected as historical matched controls. Sixty-two patients received a modified permanent TVM, where the mesh was fixed to the mid-urethra with two stitches for the purpose of potentially correcting SUI. Surgical complications were classified using the Clavien-Dindo (CD) classification system. RESULTS: The anti-SUI efficacy was minimally higher in the mTVM group than in the original TVM group (p = 0.44, 96.8% vs 91.9%, respectively), while prosthesis surgery was more effective than anterior colporrhaphy in improving the anterior compartment POP-Q status (96.8, 90.3% vs 64.5%, respectively). Anchoring the mesh did not increase the extrusion rate (p = 0.11). The de novo urge symptoms were not more prevalent among those who had received additional periurethral stitches (p = 1.00, 11.3% vs 12.9%). The incidence of reoperation observed in the mTVM group was non-significantly lower than that in the TVM group (p = 0.15, 6.5% vs 16.1%); however, the difference did not reach the level of significance. The early postoperative complication profile was more favourable among the mTVM patients (classified as CD I: 8.1%; CD II: 1.6%; and CD IIIb: 1.6%) as compared to the TVM group (p = 0.013). CONCLUSIONS: The new, modified mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications.

[Vaginal mesh operations in the urogynecological practice after the FDA warnings. Use or not to use mesh?] / Hüvelyi hálómutétek gyakorlata az amerikai korlátozó figyelmeztetés után. Merjem, vagy ne merjem?

INTRODUCTION: The prevalence of pelvic organ prolapse (POP) with aging is escalating alarmingly, and now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh (TVM) has been employed with increasing popularity in the treatment of POP until the end of the last decade. After the U.S. Drug and Food Administration (FDA) warnings in the years 2008 and 2011, the number of vaginal mesh operations has decreased dramatically. AIM: The aim of the study was to evaluate and compare the anti-POP effectivity, the anti-stress incontinence (anti-SUI) efficacy, and the late (36 months) post-operative complications of the anterior vaginoplasty and the TVM operations. METHOD: We analysed the clinical data from 120 patients with stage II-III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2013 and January 2014. Sixty patients underwent Kelly-Stoeckel vaginoplasty and the other 60 cases had TVM operation. The surgical complications were classified using the Clavien-Dindo (CD) classification system. RESULTS: The anti-POP (91.6% vs. 63.3%; p<0.001) and the anti-SUI efficacy (90% vs. 55%, p<0.001) were significantly higher in the TVM group than in the vaginoplasty group, while the overall extrusion rate was found 8.3% after a 3-year follow-up. The Clavien-Dindo score (CD) proved that the early post-operative complication profile was similar among the TVM patients as compared to the vaginoplasty group (p = 0.405). CONCLUSION: Vaginal mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications. Orv Hetil. 2018; 159(10): 397-404.

European corn borer (Ostrinia nubilalis Hbn., Lepidoptera: Crambidae): comparing the performance of a new bisexual lure with that of synthetic sex pheromone in five countries.

BACKGROUND: Phenylacetaldehyde is a flower volatile and attractant for among others the European corn borer Ostrinia nubilalis. The addition of 4-methoxyphenethyl alcohol has recently been reported to increase O. nubilalis catches four to five times, yielding a bisexual lure for the species. RESULTS: The bisexual lure significantly outperformed synthetic pheromone lures of O. nubilalis at 11 out of 13 experiments conducted in Bulgaria, Hungary, Italy, Slovenia and Turkey. CONCLUSION: The bisexual lure will provide growers with a new and efficient method for detection and monitoring of O. nubilalis. © 2017 Society of Chemical Industry.