Additional surgical risk factors and patient characteristics for mesh erosion after abdominal sacrocolpopexy

Akyol, Alpaslan; Akça, Aysu; Ülker, Volkan; Gedikbaşı, Ali; Kublay, Arzu; Han, Ağahan; Ark, Hasan Cemal; Numanoğlu, Ceyhun

doi:10.1111/jog.12363

Cited by 35 publications

(11 citation statements)

References 27 publications

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“…patients related to SUI only; and the remaining 2 533 patients in 11 studies [13,14,18,21,24,[31][32][33]36,37,41] had POP/SUI, with 1 105 of them receiving both POP and SUI procedures concomitantly. Of all eligible studies, two were randomised controlled trials (RCTs) [16,39], four were prospective cohort studies [23,32,34,35], one study consisted of a RCT and a prospective cohort study [17], three were retrospective casecontrol studies [18,21,42], and 15 were retrospective cohort studies [13][14][15]19,20,22,24,30,31,33,[36][37][38]40,41]. Of the 25 studies, nine were conducted in the USA; three in France; three in China; two each in the UK, Australia, and Turkey; one each in Chinese Taipei, Sweden, Switzerland, and the Netherlands.…”

Section: Statistics Analysismentioning

confidence: 99%

“…age, parity, and menopausal status), mesh materials, surgical procedures, operation histories and concomitant diseases (e.g. diabetes mellitus and hypertension) [13][14][15][16][17][18][19][20][21][22][23][24]. However, most risk factors remain controversial owing to the relative few patients in each study.…”

Section: Introductionmentioning

confidence: 99%

“…1). The characteristics of each eligible study are listed in Table 1 [ [13][14][15][16][17][18][19][20][21][22][23][24][30][31][32][33][34][35][36][37][38][39][40][41][42]. These studies were published between 2005 and 2014.…”

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confidence: 99%

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Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta‐analysis

et al. 2015

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ObjectivesTo explore the risk factors for mesh erosion after female pelvic floor reconstructive surgery based on published literature. Materials and MethodsA systematic literature search of the PubMed, Embase, Cochrane Library, Chinese Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI) and Chinese Science and Technology Periodical (VIP) databases was performed to identify studies related to the risk factors for mesh erosion after female pelvic floor reconstruction published before December 2014. Summary unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of associations between the factors and mesh erosion. ResultsIn all, 25 studies containing 7 084 patients were included in our systematic review and meta-analysis. Statistically significant differences in mesh erosion after female pelvic floor reconstruction were found in older vs younger patients (OR 0.96, 95% CI 0.94-0.98), more parities vs less parities (OR 1.27, 95% CI 1.07-1.51), the presence of premenopausal/ oestrogen replacement therapy (ERT) (OR 1.36, 95% CI 1.03-1.79), diabetes mellitus (OR 1.87, 95% CI 1.35-2.57), smoking (OR 2.35, 95% CI 1.80-3.08), concomitant pelvic organ prolapse (POP) surgery (OR 0.37, 95% CI 0.16-0.84), concomitant hysterectomy (OR 1.46, 95% CI 1.03-2.07), preservation of the uterus at surgery (OR 0.22, 95% CI 0.08-0.63), and surgery performed by senior vs junior surgeons (OR 0.42,). ConclusionOur study indicates that younger age, more parities, premenopausal/ERT, diabetes mellitus, smoking, concomitant hysterectomy, and surgery performed by a junior surgeon were significant risk factors for mesh erosion after female pelvic floor reconstructive surgery. Moreover, concomitant POP surgery and preservation of the uterus may be the potential protective factors for mesh erosion.

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Section: Statistics Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta‐analysis

et al. 2015

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“…Several previous studies have reported that smoking, concomitant hysterectomy, estrogen replacement therapy (ERT), and an advanced stage of POP might increase the risk of vaginal mesh erosion after SCP [10][11][12][13][14][15]. However, these studies had some methodologic limitations (e.g.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for vaginal mesh erosion after sacrocolpopexy in Korean women

Kim

Jeon

2020

PLoS ONE

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ObjectiveAlthough sacrocolpopexy (SCP) can provide durable apical support, the use of mesh may give rise to various complications, including vaginal mesh erosion. The aim of this study was to identify the risk factors for vaginal mesh erosion after SCP in Korean women. MethodsThis retrospective cohort study included 363 women who underwent SCP with type 1 polypropylene mesh. They were evaluated at 1, 4, and 12 months after surgery and then annually thereafter with respect to anatomy and complications. Univariate and multivariate analyses using the Cox proportional hazard model were performed to identify the risk factors for mesh erosion. ResultsDuring the median 2-year follow-up period, vaginal mesh erosion was found in 29 women (8.0%). Among them, 19 (65.5%) required surgical correction. Estrogenic status was the only independent risk factor for mesh erosion. The risk for mesh erosion was 4.5 times higher in premenopausal women than in menopausal women not on estrogen replacement therapy (ERT) (95% confidence intervals [CI] 1.9-10.9, p<0.01). Menopausal women on ERT also had an increased risk, with a statistically marginal significance (hazard ratio 2.5, 95% CI 0.9-6.6; p = 0.07).

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“…However, until now, a better alternative has not been available. [3][4][5][6][7] The effectiveness of a biologic patch has been the subject of much debate. 8 The current author has data collected from June 2012 to December 2017 on patients, each of whom underwent laparoscopic sacrocolpopopexy with a biologic patch consisting of a non-crosslinked ADM (Life Cell now under the ownership of Allergan).…”

Section: Introductionmentioning

confidence: 99%

Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

Karon

Chatterjee

2019

Journal of Gynecologic Surgery

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Objective: This study was conducted to evaluate the use of non-crosslinked acellular dermal matrix (ADM) in laparoscopic sacrocolpopexy by analyzing clinical outcomes and patient-satisfaction surveys. Materials and Methods: Two hundred and eleven patients underwent laparoscopic sacrocolpopexy for pelvic organ prolapse (POP) between January 6, 2012, and December 31, 2017. Each patient had her pelvic-floor measurements diagrammed with the POP-Q [Quantification] system using the interactive tool provided by the American Urogynecologic Society. The Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7), used to make comprehensive assessments of women with urogynecologic problems, were mailed to all patients. If responses were not received, the patients were contacted by telephone. Patients who were not reached by either mail or telephone had their charts individually reviewed to extract the information. Trained surveyors scored the PFDI-20 and the PFIQ-7 questionnaires. The de-identified data were analyzed for patient satisfaction and outcomes. This information was obtained by a review of patient charts at 4-week postoperative and annual examinations; any phone calls with complaints and/or problem office visits were noted. Biopsies from the sacrocolpopexy area were taken if a patient had another incidental gynecologic procedure unrelated to the prolapse or at the time of repeat sacrocolpopexy for POP and the paraffin cell block was sent to McGowan Institute for Tissue Regeneration. Results: One hundred and five patients responded to the survey. Charts were completed for 106. The majority of interviewed patients stated that they were doing a ''little better'' or ''much better'' (77/88; 87.5%). The thirdquartile PFDI-20 score was 93 with a median of 60 and the PFIQ-7 score was 43 with a median of 29. Five patients underwent reoperations (4.76%). The most-common postoperative complaint was overactive bladder symptoms, followed by vaginal discharge. Histology showed either a lack of regenerative healing tissue at the failure site or good results showing neovascularization and a presence of connective and ligamentous tissue around the matrix. No intense fibrosis or neoplastic formation was reported. Conclusions: A non-crosslinked ADM patch can be a good alternative to synthetic polypropylene mesh in patients undergoing sacrocolpopexy for POP. ( J GYNECOL SURG 35:337)

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Additional surgical risk factors and patient characteristics for mesh erosion after abdominal sacrocolpopexy

Abstract: In abdominal sacrocolpopexy operations in which polypropylene meshes are used, stage 3 or 4 prolapse, concomitant hysterectomy and three or more additional procedures increase the risk of mesh exposure development.

Cited by 35 publications

References 27 publications

Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta‐analysis

Risk factors for mesh erosion after female pelvic floor reconstructive surgery: a systematic review and meta‐analysis

Risk factors for vaginal mesh erosion after sacrocolpopexy in Korean women

Sacrocolpopexy: Patient Outcomes Support the Use of Non-Crosslinked Acellular Dermal Matrix as an Alternative to the Synthetic Polypropylene Mesh

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