Is increased affinity to canalicular P-gp via formation of lipophilic ion-pair complexes with endogenous bile salts associated with mw threshold in hepatobiliary excretion of quaternary ammonium compounds?
Mw-dependent binding of QACs to canalicular P-gp contributes in part to the mechanism of the Mw threshold of 200 +/- 50. The formation of lipophilic ion-pair complexes with bile salts, followed by stronger binding to canalicular P-gp, appears to accelerate biliary excretion of QACs with a high Mw.
Sacrocolpopexy was effective if the mesh did not become detached from its perineal position. Concomitant Burch colposuspension did not seem to affect the posterior compartment adversely in this small case series.