New insights into pelvic floor implants

In Urogynaecology, there is an ongoing search for new treatment strategies for pelvic organ prolapse (POP) and stress-urinary incontinence (SUI). Innovation and introduction of new interventions can have positive effect on healthcare, with better patient outcomes, improved efficiency or better diagnostics. The risk of implementation of new interventions are negative outcomes that can potentially be harmful to patients. Therefore, new or modified existing techniques should be well evaluated before implementation in standard care.
In this thesis we aim to evaluate (new) interventions in Urogynaecology.
In the first part of this thesis, we focus on polypropylene (PP) mesh as a treatment option for POP. We explore long-term complications of women treated with vaginal mesh surgery for POP. We evaluate health related quality of life in women after vaginal mesh surgery with and without mesh related complications. We assess the outcome of surgical interventions for complications of mesh surgery and we evaluate whether there is a causal relationship between PP implants and the development of a systemic inflammatory response or autoimmune disease.
The second part of this thesis discusses the effectiveness, safety and patient satisfaction after treatment with a bulking injection agent; polydimethylsiloxane Urolastic® (PDMS-U) as an ambulatory treatment for SUI.