title: Abdominal sacrocolpopexy for vault prolapse without burial of mesh: a case series.
abstract: OBJECTIVE
  To audit the clinical outcome of abdominal vault suspension (sacrocolpopexy, hysteropexy or cervicopexy) using non-absorbable mesh, without burial by closure of the peritoneum.
  
  
  METHODS
  A case series.
  
  
  METHODS
  Urogynaecology units of four hospitals.
  
  
  METHODS
  One hundred and twenty-eight women having open or laparoscopic sacrocolpopexy (121), hysteropexy (6) or cervicopexy (1) using non-absorbable mesh for vault prolapse.
  
  
  METHODS
  Patients had suspension of the vault, uterus or cervix from the sacral promontory using a monofilament polypropylene mesh. The pelvic peritoneum was not closed over the mesh. Patients were followed up every six months.
  
  
  METHODS
  Incidence of bowel complications as a consequence of the mesh; cure rate of prolapse and incidence of other post-operative complications; rate of re-operation for prolapse or incontinence.
  
  
  RESULTS
  After a median follow up of 19 months (1.5-62), there were no bowel complications as a result of non-burial of mesh. Three patients had asymptomatic vaginal mesh erosion, which required minor surgical intervention. Ninety percent of patients had good resolution of their prolapse symptoms while 10% of patients required further surgery.
  
  
  CONCLUSIONS
  Leaving the mesh uncovered by the pelvic peritoneum was not associated with complications. It appears safe to perform vault suspension without closing the peritoneum.
authors.affiliation: Urogynaecology Unit, Elizabeth Garrett Anderson Hospital, University College London Hospitals, Huntley Street, London WC1E 6DH, UK.
authors.forename: Sohier
authors.initials: S
authors.lastname: Elneil
authors.forename: Alfred S
authors.initials: AS
authors.lastname: Cutner
authors.forename: Mary
authors.initials: M
authors.lastname: Remy
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Leather
authors.forename: Philip
authors.initials: P
authors.lastname: Toozs-Hobson
authors.forename: Brian
authors.initials: B
authors.lastname: Wise
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D020884:Colpotomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes / Q000627:therapeutic use*; D012445:Sacrococcygeal Region / Q000601:surgery; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*
chemical_list: D011126:Polypropylenes