Mona Elena Zvâncă

Suture Materials and Technics, Possible Cause for C-Section Scar Defect

With the increasing number of births by Caesarean section a new pathology has made its presence felt, linked to the scarring of the low uterine transverse incision. It was found that after the birth by caesarean section some patients presented postmenstrual prolonged bleeding, spotting, pelvic pain and infertility. First described in 1995, the isthmocele is a healing defect in the anterior wall of the lower uterine segment at the caesarean hysterotomy site. This faulty scarring could be attributed to physiological peculiarities of the patient, to the suturing technique or ascribed to tissue reaction specifically to the type of suture material used. We found that it may be a correlation between the suture materials used and the appearance of the isthmocele. There are no large studies that asses the long-term outcome of C-section scar on prolonged menstrual bleeding, spotting and infertility and no comparison on the rate of appearance of this pathology by account of the suture material.

Painful Complications after Pelvic Floor Reconstructive Surgery in Transobturator Suburethral Vaginal Slings

Stress incontinence is a major social and health problem for middle-aged and elderly women, with an increasing prevalence as life expectancy increases. Reconstructive surgery techniques using vaginal mesh slings of polypropylene (synthetic grafts) have diversified in recent years, but at the same time various postoperative complications have been reported, among the frequent ones being pelvic pain, thigh pain and dyspareunia. The pain mechanism is not fully understood, but pathophysiological theories describe the pain as closely related to the structure, density, size and elasticity of the vaginal mesh, and the inflammatory response of the host.