Abdominal sacrocolpopexy for vault prolapse without burial of mesh: a case series.
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.
Elneil
Sohier
S
Urogynaecology Unit, Elizabeth Garrett Anderson Hospital, University College London Hospitals, Huntley Street, London WC1E 6DH, UK.
Cutner
Alfred S
AS
Remy
Mary
M
Leather
Andrew T
AT
Toozs-Hobson
Philip
P
Wise
Brian
B
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*
D011126:Polypropylenes