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Mesh erosion following abdominal sacral colpopexy in the absence and presence of the cervical stump

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Abstract

Introduction and hypothesis

We compared the role of abdominal sacral colpopexy (ASCP) with concomitant supracervical hysterectomy to ASCP alone in patients with prior hysterectomy in the prevention of mesh erosion.

Materials and methods

We performed a retrospective chart review of 277 consecutive patients who underwent ASCP with one surgeon. Patients were separated into two groups based on the presence of a uterus at the time of surgery. Group A comprised195 patients with a uterus who underwent ASCP and concomitant supracervical hysterectomy; group B comprised 82 patients with prior total hysterectomy who underwent ASCP. The outcome measures included peri- and postoperative findings, complications, and surgical success. Data were analyzed by t test and chi-square test using SPSS software.

Results

No significant difference was found between groups during surgery in terms of anesthesia type, total operative time, and estimated intraoperative blood loss. At mean postoperative follow-up of 7–8 months, there was no difference between groups in terms of de novo urinary symptoms, recurrent vaginal-wall prolapse, or dyspareunia and Pelvic Organ Prolapse Quantification (POP-Q) point C examination. Sling erosion was observed in four (4.2 %) patients in group A versus none in group B. Apical mesh erosion was diagnosed in one patient in group A (0.5 %) and two (2.4 %) patients in group B. These differences were not statistically significant.

Conclusion

Concomitant supracervical hysterectomy with ASCP was associated with a low incidence of mesh erosion and had the same intraoperative course and postoperative outcome as ASCP with previous hysterectomy.

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Abbreviations

POP:

Pelvic organ prolapse

ASCP:

Abdominal sacral colpopexy

LSCP:

Laparoscopic sacral colpopexy

POP-Q:

Pelvic Organ Prolapse Quantification

SCH:

Supracervical hysterectomy

TAH:

Total abdominal hysterectomy

USI:

Urinary stress incontinence

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA

    Shimon Ginath, Alan D. Garely & Michael D. Vardy

  2. Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, NY, USA

    Shimon Ginath & Alan D. Garely

  3. Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, and Sackler School of Medicine, Holon, Tel-Aviv, Israel

    Shimon Ginath & Alexander Condrea

  4. Department of Gynecology and Obstetrics, E. Wolfson Medical Center, P.O.B 5, Holon, 58100, Israel

    Shimon Ginath

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  1. Shimon Ginath
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  2. Alan D. Garely
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  3. Alexander Condrea
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  4. Michael D. Vardy
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Correspondence to Shimon Ginath.

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Ginath, S., Garely, A.D., Condrea, A. et al. Mesh erosion following abdominal sacral colpopexy in the absence and presence of the cervical stump. Int Urogynecol J 24, 113–118 (2013). https://doi.org/10.1007/s00192-012-1845-5

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  • DOI: https://doi.org/10.1007/s00192-012-1845-5

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