Risk of postoperative mesh exposure following sacrocolpopexy with supracervical versus total concomitant laparoscopic hysterectomy

Glass Clark, Stephanie; Bretschneider, C. Emi; Bradley, Megan S.; Rhodes, Stephen; Shoag, Jonathan; Sheyn, David

doi:10.1007/s00192-023-05658-3

Int Urogynecol J

2023

DOI: 10.1007/s00192-023-05658-3

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Risk of postoperative mesh exposure following sacrocolpopexy with supracervical versus total concomitant laparoscopic hysterectomy

Stephanie Glass Clark,

C. Emi Bretschneider,

Megan S. Bradley

et al.

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2024

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Cited by 3 publications

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Sacrocolpopexy: The Way I Do It

Shahid,

Chen,

Maher

2024

Int Urogynecol J

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Introduction and Hypothesis Sacrocolpopexy (SCP) is an established surgical procedure for apical vaginal vault prolapse. There remains significant variation amongst surgeons in both the surgical steps and concomitant surgeries utilised when undertaking an SCP. Methods This review article is aimed at summarising the evidence and providing a detailed update of SCP in modern practice, reviewing contemporary evidence behind its indications, efficacy, outcomes, surgical steps, and complications. Results Sacrocolpopexy remains the gold standard for post-hysterectomy apical prolapse based on good long-term outcomes, patient satisfaction and low complication rates. SCP with concomitant total hysterectomy is not recommended owing to high rates of mesh exposure. The laparoscopic approach remains the preferred option in terms of low morbidity, quicker recovery and lower cost than alternative access options. For optimal outcomes an SCP should be performed with monofilament mesh, using absorbable sutures and with a paravaginal repair for cystocele. Conclusions Although SCP has become increasingly utilised for apical prolapse, its established efficacy regarding anatomical outcomes, patient satisfaction, and complications is in the context of post-hysterectomy prolapse. SCP with concomitant total hysterectomy has higher rates of mesh exposure. The efficacy and safety of SCP with sub-total hysterectomy or hysteropexy have not been clearly established and require further assessment through well-designed, rigorous randomised controlled trials.

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Sacrocolpopexy: The Way I Do It

Shahid,

Chen,

Maher

2024

Int Urogynecol J

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Short-term outcomes of minimally invasive total vs supracervical hysterectomy for uterine fibroids: a National Surgical Quality Improvement Program study

Meyer,

Hamilton,

Schneyer

et al. 2024

American Journal of Obstetrics and Gynecology

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Vaginal-Assisted Laparoscopic Sacrocolpopexy (VALS) with Advanced Pelvic Organ Prolapse

Welch,

Dengler,

Gisseman

et al. 2024

Journal of Minimally Invasive Gynecology

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Risk of postoperative mesh exposure following sacrocolpopexy with supracervical versus total concomitant laparoscopic hysterectomy

Cited by 3 publications

References 21 publications

Sacrocolpopexy: The Way I Do It

Sacrocolpopexy: The Way I Do It

Short-term outcomes of minimally invasive total vs supracervical hysterectomy for uterine fibroids: a National Surgical Quality Improvement Program study

Vaginal-Assisted Laparoscopic Sacrocolpopexy (VALS) with Advanced Pelvic Organ Prolapse

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