Ultrasound imaging of slings and meshes in urogynecology

Abstract

Imaging is increasingly used in urogynaecology. One of the main applications is the imaging of synthetic implants. Ultrasound is particularly useful for this purpose as most synthetic implants appear highly echogenic on ultrasound but are invisible to other imaging techniques. The worldwide success of synthetic mid urethral slings introduced in the late 90s led to the subsequent introduction of transvaginal meshes in 2003‐2004. Widespread use of synthetic implants for both urinary incontinence and prolapse has caused a rise in implant‐ related complications and increasing negative publicity and litigation, with many products removed from markets. It is not surprising that there is increasing demand for the assessment and evaluation of sling and mesh implants by imaging. This review article will discuss the role of translabial/transperineal ultrasound in the evaluation of synthetic implants used in the treatment of urinary incontinence and pelvic organ prolapse. The discussion will focus on those applications of the technique that are useful for surgeons dealing with patients after mesh and/ or sling placement.