Rate of Mesh Erosion After Sacrocolpopexy With Concurrent Supracervical Compared With Total Hysterectomy

Nassif, Joseph; Yadav, Ghanshyam; Orejuela, Francisco J.; Turrentine, Mark A.

doi:10.1097/aog.0000000000004901

Cited by 11 publications

(3 citation statements)

References 49 publications

(364 reference statements)

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“…A patient with a history of abnormal Pap tests or elevated risk of cervical malignancy (such as HIV or high-risk human papillomavirus infection) or abnormal uterine bleeding concerning for or increased risk of endometrial hyperplasia/malignancy may choose to have her uterus completely removed. Those without a history of cervical disease may benefit by keeping the cervix in place, as this helps to reduce mesh wrinkling and is associated with lower rates of mesh exposure 2 …”

Section: Complete Versus Supracervical Hysterectomymentioning

confidence: 99%

At the Scrub Sink: Minimally Invasive Sacrocolopexy

Moalli

2024

UROGC

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Section: Complete Versus Supracervical Hysterectomymentioning

confidence: 99%

At the Scrub Sink: Minimally Invasive Sacrocolopexy

Moalli

2024

UROGC

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“…In the last decades, the FDA, starting from the literature data, have unquestionably stated that opening the vagina during prosthetic prolapse reconstruction surgery should be avoided and, in particular during sacral colpopexy, the risk of erosion statistically increases in cases of vaginal incision-opening for total hysterectomy [16].…”

Section: Discussionmentioning

confidence: 99%

Quality of Life and Sexual Function after Laparoscopic Posterior Vaginal Plication Plus Sacral Colpopexy for Severe Posterior Vaginal Prolapse

Morciano,

Schiavi,

Frigerio

et al. 2024

JCM

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Background: Laparoscopic sacral colpopexy (LSC) is the gold standard treatment for women with apical/anterior pelvic organ prolapse (POP). For isolated posterior vaginal prolapse, instead, the literature suggests fascial native tissue repair. This is a retrospective 2-year quality-of-life follow-up study after laparoscopic posterior plication (LPP) combined with LSC in patients with anterior/apical prolapse combined with severe posterior colpocele. The primary endpoint was to evaluate the subjective outcomes quality of life (QoL), sexual function, and patient satisfaction rate. The secondary endpoint was to evaluate perioperative and anatomical outcomes at the 2-year follow-up. Methods: A total of 139 consecutive patients with anterior and/or apical prolapse (POP-Q stage ≥ II) and severe posterior vaginal prolapse (posterior POP-Q stage ≥ III) were retrospectively selected from our database among women who underwent, from November 2018 to February 2021, a “two-meshes” LSC. The patients were classified into Group A (81 patients; LSC plus LPP) and Group B (67 patients; LSC alone). The primary endpoint was evaluated using the Patient Global Impression of Improvement (PGI-I), the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), the Female Sexual Distress Scale (FSDS), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and the EuroQol (EQ-5D). The secondary endpoint was studied using the POP-Q study and an intra-, peri-, and post-operative complications assessment. Two-year follow-up data were analyzed for the study. Results: At 2 years, all women showed a statistically significant amelioration of their symptoms on the QoL questionnaires. We found a statistical difference in favor of posterior plication in terms of the PGI-I successful outcome rate (Group A versus B: 85.3% versus 67.1%), FSDS (median 11 versus 21), and PISQ-12 (median 89 versus 62) (p < 0.05 for all comparisons). A significant improvement of all EQ-5D values was observed from baseline to 2-year follow-up, and only for the “pain/discomfort” domains did we observe a significant improvement in LSC plus LPP patients versus LSC alone (p < 0.05). LSC plus LPP women showed, at 2 years, a significant amelioration of their Ap and GH POP-Q points. We observed no statistical differences in terms of intra-post-operative complications or anatomic failure rate between groups. Conclusions: Our LPP approach to LSC appears to be a safe, feasible, and effective treatment for advanced pelvic organ prolapse with a significant impact on the patient’s general health and sexual quality of life. Adding laparoscopic posterior vaginal plication to “two-meshes” sacral colpopexy is recommended in patients with apical/anterior prolapse and concomitant severe posterior colpocele. This surgical approach, in addition to improving the anatomical results of these patients, is associated with a significant improvement in sexual and quality of life indexes.

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“…In the largest observational cohort study by van Zanten et al [ 18 ], mesh exposure rates were similar for both robotic procedures (2.1% for TH vs. 0.9% for SCH; P >0.999). A most recent systemic analysis review of 19 studies for rate of mesh erosion demonstrated that SCH had a lower rate of mesh erosion than that in TH (combined odds ratio [OR], 0.26; 95% confidence interval [CI], 0.18–0.38; I 2 , 0%) [ 21 ]. This review suggested that this may be due to the opening of the vaginal cuff weakening the tissue because of vaginal bacteria, tissue devascularization, or loss of structural support of the cervix for mesh or suture attachment.…”

Section: Sacrocervicopexy Vs Sacrocolpopexymentioning

confidence: 99%

Robotic sacrocolpopexy

Mozon,

Kim,

Lee

2024

Obstet Gynecol Sci

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Pelvic organ prolapse (POP) is a common cause of gynecological disease in elderly women. The prevalence of POP has increased with an aging society. Abdominal sacrocolpopexy (ASC) is safer and more effective than the vaginal approach in patients with apical compartment POP because it has a higher anatomical cure rate, a lower recurrence rate, less dyspareunia, and improved sexual function. Laparoscopic sacrocolpopexy (LSC) has replaced ASC. Robotic sacrocolpopexy (RSC) also helps overcome the challenges of LSC by facilitating deep pelvic dissection and multiple intracorporeal suturing. The RSC is technically easy to apply, has a steep learning curve, and offers many advantages over the LSC. However, insufficient data led us to conclude that the LSC is superior overall, especially in terms of costeffectiveness. The present review provides insights into different aspects of RSC, highlighting the most common benefits and concerns of this procedure. We searched for eligible articles discussing this issue from January 2019 to March 2022 to reveal the outcomes of RSC.

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Rate of Mesh Erosion After Sacrocolpopexy With Concurrent Supracervical Compared With Total Hysterectomy

Cited by 11 publications

References 49 publications

At the Scrub Sink: Minimally Invasive Sacrocolopexy

At the Scrub Sink: Minimally Invasive Sacrocolopexy

Quality of Life and Sexual Function after Laparoscopic Posterior Vaginal Plication Plus Sacral Colpopexy for Severe Posterior Vaginal Prolapse

Robotic sacrocolpopexy

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