[Impact of vaginal mesh exposure on quality of life in patients undergoing transvaginal reconstructive pelvic surgery with polypropylene mesh].

OBJECTIVE: To study the impact of vaginal mesh exposure on quality of life in patients undergoing transvaginal reconstructive pelvic surgery (RPS) with polypropylene mesh. METHODS: From May 2004 to March 2011, 114 patients with severe pelvic organ prolapse (POP) undergoing transvaginal RPS with polypropylene mesh were enrolled in this study, which were divided into exposure and non-exposure group according to appearing vaginal mesh exposure at 2 months, 6 months and 1 year after operation. At the same time, pelvic floor distress inventory short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were completed in those patients. RESULTS: At 2 months after operation, 96 patients were followed up, including 19 patients in exposure group and 77 patients in non-exposure group, and the rate of exposure was 19.8% (19/96); At 6 months after operation, 85 patients were followed up, including 13 patients in exposure group and 72 patients in non-exposure group, and the rate of exposure was 15.3% (13/85); At 1 year after operation, 77 patients were followed up, including 6 patients in exposure group and 71 patients in non-exposure group, and the rate of exposure was 7.8% (6/77). Mean score of PFDI-20 and PFIQ-7 in exposure group before operation was 39.6 and 57.1, which was statistically improved to 8.3 and 9.5 at 2 months after operation, 8.3 and 9.5 at 6 months after operation, 2.1 and 0 in 1 year after operation (P < 0.01). Mean score of PFDI-20 and PFIQ-7 of non-exposure group before operation was 54.2 and 66.7, which was improved to 8.3 and 4.8 at 2 months after operation, 0 at 6 months and 1 year after operation, but there was no significant difference in mean score of PFDI-20 and PFIQ-7 between the two groups (P > 0.05). CONCLUSION: Vaginal mesh exposure was common after transvaginal RPS with polypropylene mesh, however, most of them were moderate, and there was no significant impact on patients' qualifies of life.

Study on Fabrication and UV Photoelectric Property of TiO2 Nanotube Array Electrodes.

Highly ordered TiO2 nanotube array electrodes were successfully fabricated by a two-step anodization method on Ti sheet substrates in an electrolyte composed of ammonium fluoride, deionized water, and glycol. The tube wall was smooth, and the average internal and external diameters, wall thickness, and tube length achieved were 80 nm, 90 nm, 10 nm, and 9 µm, respectively. X-ray diffraction and field emission scanning electron microscopy results revealed that the TiO2 nanotube arrays presented an amorphous structure. When calcined at 300 °C, the arrays crystallized into the anatase phase, and the crystallization degree of the oxide layer increased as the temperature rose. Calcinating at 400 °C did not obviously disrupt the porous structure of the highly ordered arrays. However, higher temperature enlarged the diameter of the nanotube array and roughened the tube wall. When the temperature reached 600 °C, the nanotube mouth broke because of the excessive stress, causing the oxide layer's thinness and nanotube mouth clogging. The photoelectric test showed that the electrode presented obvious photoresponse under 300-400 nm UV excitation (maximized at 360 nm). The degree of crystallization and the micro-structure of the oxide layer can significantly affect the photoelectric properties of the electrode. After calcination at 400 °C, the TiO2 nanotube arrays, with highly ordered tubular structure directly connected to the Ti substrate, can ensure the rapid transportation of photo-induced electrons to the Ti substrate, while the high crystallinity of the arrays can help reduce the defect density of the nanotube and extend the lifetime of the photo-induced carriers. The electrode showed the best photoelectric property, and the photocurrent intensity was maximized (29.6 µA). However, the calcination process with over-temperature resulted in substantial loss of the TiO2 oxide layer, mouth clogging, and a severe decline in the photoelectric properties.

Risk Factors for Mesh Exposure after Transvaginal Mesh Surgery.

BACKGROUND: Mesh exposure after surgery continues to be a clinical challenge for urogynecological surgeons. The purpose of this study was to explore the risk factors for polypropylene (PP) mesh exposure after transvaginal mesh (TVM) surgery. METHODS: This study included 195 patients with advanced pelvic organ prolapse (POP), who underwent TVM from January 2004 to December 2012 at the First Affiliated Hospital of Chinese PLA General Hospital. Clinical data were evaluated including patient's demography, TVM type, concomitant procedures, operation time, blood loss, postoperative morbidity, and mesh exposure. Mesh exposure was identified through postoperative vaginal examination. Statistical analysis was performed to identify risk factors for mesh exposure. RESULTS: Two-hundred and nine transvaginal PP meshes were placed, including 194 in the anterior wall and 15 in the posterior wall. Concomitant tension-free vaginal tape was performed in 61 cases. The mean follow-up time was 35.1 ± 23.6 months. PP mesh exposure was identified in 32 cases (16.4%), with 31 in the anterior wall and 1 in the posterior wall. Significant difference was found in operating time and concomitant procedures between exposed and nonexposed groups (F = 7.443, P = 0.007; F = 4.307, P = 0.039, respectively). Binary logistic regression revealed that the number of concomitant procedures and operation time were risk factors for mesh exposure (P = 0.001, P = 0.043). CONCLUSION: Concomitant procedures and increased operating time increase the risk for postoperative mesh exposure in patients undergoing TVM surgery for POP.