Indian Journal of Urology
LETTER TO EDITOR
Year
: 2013  |  Volume : 29  |  Issue : 1  |  Page : 85-

Pelvic floor repair


Surajit Bhattacharya 
 Sr. Consultant, Plastic, Reconstructive and Aesthetic Surgery, Sahara Hospital, Lucknow, India

Correspondence Address:
Surajit Bhattacharya
C- 907 Mahanagar, Secter B, Lucknow - 226 006, Uttar Pradesh
India




How to cite this article:
Bhattacharya S. Pelvic floor repair.Indian J Urol 2013;29:85-85


How to cite this URL:
Bhattacharya S. Pelvic floor repair. Indian J Urol [serial online] 2013 [cited 2020 Nov 25 ];29:85-85
Available from: https://www.indianjurol.com/text.asp?2013/29/1/85/110000


Full Text

Dear Sir,

I read the paper "Trans-vaginal total pelvic floor repair using customized prolene mesh: A safe and cost-effective approach for high-grade pelvic organ prolapse" by Chaturvedi et al. [1] with great interest. I congratulate the authors for presenting a reasonably large series of transvaginal pelvic reconstructive effort and have two observations.

Instead of suture passer needles, I feel a tendon tunneler could be used. This comes in both straight and curved shapes and while the former can be used to pass the anterior limbs of the proline mesh around the bladder, the latter can be used to pass the posterior limbs around the rectum. Tendon tunnelers are round tipped and hence non-traumatic and can directly catch the limbs of the proline mesh, thus obviating the extra steps of first passing a thread with suture, then tying the suture to the mesh and subsequently pulling it.

If mesh erosion still remains a potential complication, we can replace it with biological tissue. Fascia lata can be harvested in an endoscopy assisted manner and a similar template can be constructed with it using proline sutures. This will add a bit to the operating time but will further bring down the cost of this surgery.

References

1Chaturvedi S, Bansal R, Ranjan P, Ansari MS, Kapoor D, Kapoor R. Trans-vaginal total pelvic floor repair using customized prolene mesh: A safe and cost-effective approach for high-grade pelvic organ prolapse. Indian J Urol 2012;28:21-7.