A Streamlined Surgical Approach to Laparoscopic Sacrocolpopexy for Post-Hysterectomy Vault Prolapse

Zebede, Salomón; Dawood, Ashraf; Alarab, May; Drutz, Harold P.; Lovatsis, Danny

doi:10.1016/j.jogc.2016.01.006

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…In a study of 144 patients with a 32-month follow-up, a technique involving limited mesh attachment to the vagina without vaginal plane dissection was employed. This approach achieved a high anatomical success rate of 97%, with no occurrences of cystotomies or vaginal mesh exposures 24 . In a study involving 121 women and a 33-month follow-up period, it was demonstrated that anchoring meshes solely to the vaginal apex, even in cases of multicompartmental vaginal prolapse, proved effective, efficient, and time saving.…”

Section: Discussionmentioning

confidence: 98%

“…This approach achieved a high anatomical success rate of 97%, with no occurrences of cystotomies or vaginal mesh exposures. 24 In a study involving 121 women and a 33-month follow-up period, it was demonstrated that anchoring meshes solely to the vaginal apex, even in cases of multicompartmental vaginal prolapse, proved effective, efficient, and time saving. This approach was found to be sufficient for correcting other vaginal compartments as well.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Zhao,

Liu,

Cui

et al. 2024

UROGC

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Importance As an increasing number of mesh-related complications have been reported, the availability of nonmesh alternatives becomes crucial for situations where mesh is not desired or unavailable. A new modified procedure of nonmesh laparoscopic sacral colpopexy (LSC) was performed in our department, which used a nonabsorbable polyester suture (Ethibond) combined with uterosacral ligament suspension. Objective The aim of this study was to evaluate the clinical efficacy of the modified procedure in comparison with traditional LSC in patients with pelvic organ prolapse. Methods This retrospective study assessed the treatment outcomes of 60 patients who were underwent LSC with or without mesh from January 2017 to April 2019. Patients were divided into 2 groups based on the presence or absence of mesh during the operation: mesh group (n = 34) and nonmesh group (n = 26). General data, perioperative indexes, postoperative complications, and recurrence rates were comparatively analyzed between 2 groups. Results In perioperative indexes, the nonmesh group exhibited shorter operation time (P < 0.001) and less intraoperative blood loss compared with the mesh group (P = 0.004). There was no significant difference in postoperative indwelling urinary catheter duration (P = 0.425) and hospitalization time (P = 0.827) between the 2 groups. In postoperative complications, the incidence of postoperative complications showed no significant difference between the 2 groups (P > 0.05). No occurrences of mesh exposure and erosion were observed in the mesh group during at least a 2-year follow-up period. In postoperative recurrence, none of the patients in either group experienced prolapse recurrence. Conclusions In comparison with the traditional LSC with mesh, the modified laparoscopic nonmesh sacral colpopexy presents advantages of reduced surgical trauma, less pain, and lower cost. However, a long-term and large sample study is required for evaluating the surgery’s long-term efficacy.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Zhao,

Liu,

Cui

et al. 2024

UROGC

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Long-term mesh erosion rate following abdominal robotic reconstructive pelvic floor surgery: a prospective study and overview of the literature

et al. 2019

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Introduction and hypothesis The use of synthetic mesh in transvaginal pelvic floor surgery has been subject to debate internationally.Although mesh erosion appears to be less associated with an abdominal approach, the long-term outcome has not been studied intensively. This study was set up to determine the long-term mesh erosion rate following abdominal pelvic reconstructive surgery. Methods A prospective, observational cohort study was conducted in a tertiary care setting. All consecutive female patients who underwent robot-assisted laparoscopic sacrocolpopexy and sacrocolporectopexy in 2011 and 2012 were included. Primary outcome was mesh erosion. Preoperative and postoperative evaluation (6 weeks, 1 year, 5 years) with a clinical examination and questionnaire regarding pelvic floor symptoms was performed. Mesh-related complications were assessed using a transparent vaginal speculum, proctoscopy, and digital vaginal and rectal examination. Kaplan-Meier estimates were calculated for mesh erosion. A review of the literature on mesh exposure after minimally invasive sacrocolpopexy was performed (≥12 months' follow-up).Results Ninety-six of the 130 patients included (73.8%) were clinically examined. Median follow-up time was 48.1 months (range 36.0-62.1). Three mesh erosions were diagnosed (3.1%; Kaplan-Meier 4.9%, 95% confidence interval 0-11.0): one bladder erosion for which mesh resection and an omental patch interposition were performed, and two asymptomatic vaginal erosions (at 42.7 and 42.3 months) treated with estrogen cream in one. Additionally, 22 patients responded solely by questionnaire and/or telephone; none reported mesh-related complaints. The literature, mostly based on retrospective studies, described a median mesh erosion rate of 1.9% (range 0-13.3%). Conclusions The long-term rate of mesh erosion following an abdominally placed synthetic graft is low.

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Mesh exposure following minimally invasive sacrocolpopexy: a narrative review

2022

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A Streamlined Surgical Approach to Laparoscopic Sacrocolpopexy for Post-Hysterectomy Vault Prolapse

Cited by 5 publications

References 15 publications

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Clinical Efficacy of Modified Nonmesh Sacral Colpopexy for Pelvic Organ Prolapse

Long-term mesh erosion rate following abdominal robotic reconstructive pelvic floor surgery: a prospective study and overview of the literature

Mesh exposure following minimally invasive sacrocolpopexy: a narrative review

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