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Long-term pelvic organ prolapse recurrence and mesh exposure following sacrocolpopexy

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International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Large, long-term studies are needed to compare pelvic organ prolapse (POP) recurrence and mesh exposure following all modes of sacrocolpopexy (open, robotic, and laparoscopic). We hypothesized that the prevalence of recurrent POP and mesh exposure does not differ between modes of sacrocolpopexy.

Methods

This is a retrospective cohort study with a cross-sectional, prospective survey. Participants were surveyed regarding complications, retreatments, and symptoms following sacrocolpopexy. Baseline characteristics, POP recurrence, mesh exposure, and survey responses were compared.

Results

A total of 709 participants met the criteria. Median time from sacrocolpopexy to last follow-up for all participants was 0.5 years (2 days to 13.4 years). 15.0% experienced recurrent stage 2 or greater POP or underwent retreatment (open 11.7% [95% CI 7.8–17.2%]; robotic 21.1% [95% CI 15.6–27.9%]; laparoscopic 13.8% [95% CI 10.6–17.9%]; p = 0.03). After adjusting for baseline differences there was no significant difference among groups (p = 0.30). 5.3% experienced mesh and/or suture exposure (mesh n = 19, suture n = 10, mesh and suture n = 8) with no significant difference among groups (open 7.7% [95% CI 4.6–12.5%]; robotic 3.6% [95% CI 1.7–7.6%]; laparoscopic 4.9% [95% CI 3.1–7.7%]; p = 0.20). Median time from sacrocolpopexy to survey completion was 6.5 (1.6–13.4) years. 9.2% reported evaluation or treatment for recurrent POP (open 6.3% [95% CI 2.1–16.8%]; robotic 12.5% [95% CI 6.9–21.5%]; laparoscopic 8.5% [5.1–13.8%]; p = 0.44). 6.9% reported evaluation or treatment for mesh exposure (open 6.0% [95% CI 2.1–16.2%]; robotic 3.9% [95% CI 1.3–10.7%]; laparoscopic 8.6% [5.2–13.9%]; p = 0.38).

Conclusions

Objective and patient-reported long-term prevalence of POP recurrence and mesh exposure are low following all modes of sacrocolpopexy.

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Funding

There was no financial support for this study.

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Authors and Affiliations

  1. Center for Urogynecology & Pelvic Reconstructive Surgery, Obstetrics, Gynecology & Women’s Health Institute, Cleveland Clinic, 9500 Euclid Avenue A81, Cleveland, OH, 44195, USA

    Tonya N. Thomas, Emily R. W. Davidson, Erika J. Lampert, Marie F. R. Paraiso & Cecile A. Ferrando

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  1. Tonya N. Thomas
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  2. Emily R. W. Davidson
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  3. Erika J. Lampert
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  4. Marie F. R. Paraiso
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  5. Cecile A. Ferrando
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Contributions

T.N. Thomas: protocol/project development, data collection and management, data analysis, manuscript writing and editing; E.R.W. Davidson: data collection and management, data analysis, manuscript editing; E.J. Lampert: data collection, manuscript editing; M.F.R. Paraiso: protocol/project development, manuscript editing; C.A. Ferrando: protocol/project development, data collection and management, data analysis, manuscript editing.

Corresponding author

Correspondence to Tonya N. Thomas.

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Conflicts of interest

T.N. Thomas, C.A. Ferrando, and M.F.R. Paraiso are authors for and receive royalties from UpToDate, Inc. (Waltham, MA, USA); C.A. Ferrando and M.F.R. Paraiso received unrestricted research grants from Caldera, Inc. (Agoura Hills, CA, USA) and Coloplast, Inc. (Minneapolis, MN, USA); E.R.W. Davidson is an independent consultant for the International Academy of Pelvic Surgery (Sanibel, FL, USA). E.J. Lampert declares no conflicts of interest.

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Thomas, T.N., Davidson, E.R.W., Lampert, E.J. et al. Long-term pelvic organ prolapse recurrence and mesh exposure following sacrocolpopexy. Int Urogynecol J 31, 1763–1770 (2020). https://doi.org/10.1007/s00192-020-04291-8

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  • DOI: https://doi.org/10.1007/s00192-020-04291-8

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