Prevalence and risk factors for mesh erosion after laparoscopic-assisted sacrocolpopexy

Tan-Kim, Jasmine; Menefee, Shawn A.; Luber, Karl M.; Nager, Charles W.; Lukacz, Emily S.

doi:10.1007/s00192-010-1265-3

Cited by 157 publications

(96 citation statements)

References 29 publications

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“…Similar rates have been reported in LSCP, although a recent review of more than 1000 cases reporting a mean rate of 2.7% [15]. Another however, found a substantially higher exposure rate of 10% with a rate of 23% in those patients undergoing concurrent vaginal hysterectomy [21].…”

Section: Discussionsupporting

confidence: 61%

Sacrocolpopexy (SCP) - A Cohort Study Looking at Short, Medium and Long Term Outcome

Hawthorn¹

2013

Med Surg Urol

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In this study we evaluate the outcome, complications and need for repeat surgery after Sacrocolpopexy (SCP) over the last 10 years. 49 (66%) case notes were reviewed. 28 (57%) patients SCP. The remainder had concomitant pelvic floor and / or incontinence procedures.12 patients had laparoscopic SCP and 37 were performed by open technique. 8(16%) patients' required further surgery either for new prolapse or recurrent prolapse.The short term success with sacrocolpopexy was high (97.9%) with the rate being maintained with medium term (100%) and long term (91.66%) follow up. Rates of complication, especially mesh exposure, was very low in our study. This suggests maintaining the integrity of vaginal vault during SCP might be a key factor in reducing the incidence of mesh exposure with SCP.However large numbers in long term follow up is needed to make any definite conclusion. Sacrocolpopexy (SCP) -A cohort study looking at short, medium and long term outcome.

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Section: Discussionsupporting

confidence: 61%

Sacrocolpopexy (SCP) - A Cohort Study Looking at Short, Medium and Long Term Outcome

Hawthorn¹

2013

Med Surg Urol

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“…On the basis of a previous publication, we have determined that there is a 6-fold increase in vaginal mesh erosion when associated with hysterectomy. 13 We noted a significant difference in the mesh erosion rate between patients receiving a concurrent hysterectomy (23%) and those who did not (10%).…”

mentioning

confidence: 72%

A Pilot Study Comparing Anatomic Failure after Sacrocolpopexy with Absorbable or Permanent Sutures for Vaginal Mesh Attachment

Tan-Kim

Menefee

Lippmann

et al. 2014

TPJ

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“…The incidence of mesh erosion after sacrocolpopexy is as high as 14-23% when mesh is placed over an incision, such as in a total hysterectomy. Cervical retention can reduce this risk to 0-5% [4,5]. Mesh erosion can confer significant morbidity in the form of infection, painful intercourse, and additional surgeries to repair the erosion.…”

Section: Discussionmentioning

confidence: 99%

“…The most common mesh-related complication is vaginal mesh erosion [3]. The risk of mesh erosion decreases with retention of the cervix for mesh attachment from as high as 14-23% to 0-5% [4,5]. For this reason most hysterectomies performed at the time of concomitant sacral colpopexies are supracervical and, when performed minimally-invasively, the specimen is usually morcellated.…”

Section: Introductionmentioning

confidence: 99%

Uterine Pathology in Hysterectomies Performed for Treatment of Pelvic Organ Prolapse

Ra²,

Mm³

et al. 2016

Adv Cancer Prev

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Objective: To determine the rate of uterine pathology in hysterectomies performed during surgery for treatment of uterovaginal prolapse. Methods:In this retrospective cohort study, we evaluated all patients undergoing hysterectomy during treatment of uterovaginal prolapse at a single academic institution from 2008 to 2013. Demographics, risk factors for uterine malignancy, operative data, and pathology reports were reviewed. Patients with history of concerning uterine pathology were excluded.Results: 339 subjects were included; none were excluded. Mean age of patients undergoing hysterectomy was 63.2 years with 85.5% post-menopausal. Mean BMI was 27 kg/m 2 and mean uterine weight was 71 grams. Abnormal pathology was identified in 0.8% (3/339) subjects: complex atypical hyperplasia (1), grade 1 endometrial adenocarcinoma (1), and low-grade B-cell lymphoma (1). 49% of specimens contained fibroids and no sarcomas were identified. Total hysterectomy was performed in 88%. 12% (40/339) underwent supracervical hysterectomy with morcellation. One specimen with abnormal pathology (complex atypical hyperplasia) was morcellated. Patients undergoing procedures requiring morcellation were younger (57.3 vs. 63.3, p=.001, 95%CI 2.52, 9.52) and less likely to be postmenopausal (69% vs. 88%, p=.021, 95%CI .067, .300). Risk factors for uterine malignancy were not different between groups. Conclusions:We found a low rate of incidental uterine pathology in hysterectomy specimens from prolapse surgery. Half of uterine specimens had leiomyomas. Specimens with fibroids had a higher mean weight than leiomyoma-free specimens. Risk factors for cancers among patients undergoing morcellation versus intact removal were not different. Further study is needed to clarify the role of morcellation in this low-risk population.

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Prevalence and risk factors for mesh erosion after laparoscopic-assisted sacrocolpopexy

Cited by 157 publications

References 29 publications

Sacrocolpopexy (SCP) - A Cohort Study Looking at Short, Medium and Long Term Outcome

Sacrocolpopexy (SCP) - A Cohort Study Looking at Short, Medium and Long Term Outcome

A Pilot Study Comparing Anatomic Failure after Sacrocolpopexy with Absorbable or Permanent Sutures for Vaginal Mesh Attachment

Uterine Pathology in Hysterectomies Performed for Treatment of Pelvic Organ Prolapse

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