Prevalence and Risk Factors for Mesh Erosion After Laparoscopic-assisted Sacrocolpopexy

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2010 Sep 16

PMID 20842494

Citations 56

Authors

Jasmine Tan-Kim

Shawn A Menefee

Karl M Luber

Charles W Nager

Emily S Lukacz

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: The purpose of this study is to identify risk factors for mesh erosion in women undergoing minimally invasive sacrocolpopexy (MISC). We hypothesize that erosion is higher in subjects undergoing concomitant hysterectomy.

Methods: This is a retrospective cohort study of women who underwent MISC between November 2004 and January 2009. Demographics, operative techniques, and outcomes were abstracted from medical records. Multivariable regression identified odds of erosion.

Results: Of 188 MISC procedures 19(10%) had erosions. Erosion was higher in those with total vaginal hysterectomy (TVH) compared to both post-hysterectomy (23% vs. 5%, p = 0.003) and supracervical hysterectomy (SCH) (23% vs. 5%, p = 0.109) groups. In multivariable regression, the odds of erosion for TVH was 5.67 (95% CI: 1.88-17.10) compared to post-hysterectomy. Smoking, the use of collagen-coated mesh, transvaginal dissection, and mesh attachment transvaginally were no longer significant in the multivariable regression model.

Conclusion: Based on this study, surgeons should consider supracervical hysterectomy over total vaginal hysterectomy as the procedure of choice in association with MISC unless removal of the cervix is otherwise indicated.

Citing Articles

Influencing factors of recurrence after pelvic organ prolapse surgery and construction of a nomogram risk prediction model.

Zhang P, Du W, Guo G, Yuan M, Wei J Rev Assoc Med Bras (1992). 2024; 70(12):e20240849.

PMID: 39630722 PMC: 11639548. DOI: 10.1590/1806-9282.20240849.

Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) in Urogynecological Surgery: A Systematic Review.

Vacca L, Rosato E, Lombardo R, Geretto P, Albisinni S, Campi R J Clin Med. 2024; 13(19).

PMID: 39407766 PMC: 11477206. DOI: 10.3390/jcm13195707.

Sacrocolpopexy: The Way I Do It.

Shahid U, Chen Z, Maher C Int Urogynecol J. 2024; 35(11):2107-2123.

PMID: 39404818 PMC: 11638296. DOI: 10.1007/s00192-024-05922-0.

Laparoscopic Sacrohysteropexy for Pelvic Organ Prolapse and the Technique Used for Uterine Preservation: A Case Report.

Nishii S, Ishikawa T, Okada Y, Sekizawa A Cureus. 2024; 16(2):e54989.

PMID: 38550503 PMC: 10972782. DOI: 10.7759/cureus.54989.

Long-Term Mesh Exposure 5 Years Following Minimally Invasive Total Hysterectomy and Sacrocolpopexy.

Bretschneider C, Myers E, Geller E, Kenton K, Henley B, Matthews C Int Urogynecol J. 2024; 35(4):901-907.

PMID: 38530401 PMC: 11052764. DOI: 10.1007/s00192-024-05769-5.

References

Lowman J, Woodman P, Nosti P, Bump R, Terry C, Hale D . Tobacco use is a risk factor for mesh erosion after abdominal sacral colpoperineopexy. Am J Obstet Gynecol. 2008; 198(5):561.e1-4. DOI: 10.1016/j.ajog.2008.01.048. View

Kohli N, Walsh P, Roat T, Karram M . Mesh erosion after abdominal sacrocolpopexy. Obstet Gynecol. 1998; 92(6):999-1004. DOI: 10.1016/s0029-7844(98)00330-5. View

Begley J, Kupferman S, Kuznetsov D, Kobashi K, Govier F, McGonigle K . Incidence and management of abdominal sacrocolpopexy mesh erosions. Am J Obstet Gynecol. 2005; 192(6):1956-62. DOI: 10.1016/j.ajog.2005.02.062. View

Sarlos D, Brandner S, Kots L, Gygax N, Schaer G . Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical results, quality of life and perioperative outcome-a prospective study with 101 cases. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19(10):1415-22. DOI: 10.1007/s00192-008-0657-0. View

Ross J . Techniques of laparoscopic repair of total vault eversion after hysterectomy. J Am Assoc Gynecol Laparosc. 1997; 4(2):173-83. DOI: 10.1016/s1074-3804(97)80006-0. View

Klauschie J, Suozzi B, OBrien M, McBride A . A comparison of laparoscopic and abdominal sacral colpopexy: objective outcome and perioperative differences. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 20(3):273-9. DOI: 10.1007/s00192-008-0768-7. View

Ross J . The use of a xenogenic barrier to prevent mesh erosion with laparoscopic sacrocolpopexy. J Minim Invasive Gynecol. 2007; 14(4):470-4. DOI: 10.1016/j.jmig.2007.02.003. View

Su K, Mutone M, Terry C, Hale D . Abdominovaginal sacral colpoperineopexy: patient perceptions, anatomical outcomes, and graft erosions. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 18(5):503-11. DOI: 10.1007/s00192-006-0196-5. View

Bensinger G, Lind L, Lesser M, Guess M, Winkler H . Abdominal sacral suspensions: analysis of complications using permanent mesh. Am J Obstet Gynecol. 2005; 193(6):2094-8. DOI: 10.1016/j.ajog.2005.07.066. View

10.

Stepanian A, Miklos J, Moore R, Mattox T . Risk of mesh extrusion and other mesh-related complications after laparoscopic sacral colpopexy with or without concurrent laparoscopic-assisted vaginal hysterectomy: experience of 402 patients. J Minim Invasive Gynecol. 2008; 15(2):188-96. DOI: 10.1016/j.jmig.2007.11.006. View

11.

Ganatra A, Rozet F, Sanchez-Salas R, Barret E, Galiano M, Cathelineau X . The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009; 55(5):1089-103. DOI: 10.1016/j.eururo.2009.01.048. View

12.

Maher C, Qatawneh A, Dwyer P, Carey M, Cornish A, Schluter P . Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol. 2004; 190(1):20-6. DOI: 10.1016/j.ajog.2003.08.031. View

13.

Olsen A, Smith V, Bergstrom J, Colling J, Clark A . Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997; 89(4):501-6. DOI: 10.1016/S0029-7844(97)00058-6. View

14.

Ross . Laparoscopic Approach for Severe Pelvic Vault Prolapse. J Am Assoc Gynecol Laparosc. 1996; 3(4, Supplement):S43. View

15.

Cundiff G, Varner E, Visco A, Zyczynski H, Nager C, Norton P . Risk factors for mesh/suture erosion following sacral colpopexy. Am J Obstet Gynecol. 2008; 199(6):688.e1-5. PMC: 2859033. DOI: 10.1016/j.ajog.2008.07.029. View

16.

de Tayrac R, Alves A, Therin M . Collagen-coated vs noncoated low-weight polypropylene meshes in a sheep model for vaginal surgery. A pilot study. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 18(5):513-20. DOI: 10.1007/s00192-006-0176-9. View

17.

Paraiso M, Walters M, Rackley R, Melek S, Hugney C . Laparoscopic and abdominal sacral colpopexies: a comparative cohort study. Am J Obstet Gynecol. 2005; 192(5):1752-8. DOI: 10.1016/j.ajog.2004.11.051. View

18.

Bump R, Mattiasson A, Bo K, Brubaker L, DeLancey J, Klarskov P . The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996; 175(1):10-7. DOI: 10.1016/s0002-9378(96)70243-0. View

19.

Vollebregt A, Troelstra A, Huub van der Vaart C . Bacterial colonisation of collagen-coated polypropylene vaginal mesh: are additional intraoperative sterility procedures useful?. Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20(11):1345-51. PMC: 2762530. DOI: 10.1007/s00192-009-0951-5. View

20.

Ross J, Preston M . Laparoscopic sacrocolpopexy for severe vaginal vault prolapse: five-year outcome. J Minim Invasive Gynecol. 2005; 12(3):221-6. DOI: 10.1016/j.jmig.2005.03.017. View