title: Abdominovaginal sacral colpoperineopexy: patient perceptions, anatomical outcomes, and graft erosions.
abstract: This is a retrospective analysis of 169 consecutive patients who underwent the abdominovaginal sacral colpoperineopexy. POP-Q measurements, patient willingness to have the same surgery again, and mesh erosions were recorded during follow-up visits. Patients whose erosion responded to office excision were defined as having minor mesh erosion. Patients with persistent erosions requiring outpatient surgical excisions were defined as having major mesh erosion. For the 122 patients with 12-month follow-up, all POP-Q points improved (p<0.005) compared with preoperative measurements. The response to the question "Would you go through the same surgery again?" was "yes" 77.3% of the time and "no" 4.9% of the time. Minor mesh erosion rate was 5.9% (10/169). Major erosion rate was 0.6% (1/169). In conclusion, when combined with paravaginal defect repair and Burch urethropexy, the abdominovaginal sacral colpoperineopexy effectively addresses all support defects in patients with advanced prolapse. The procedure is associated with a high level of patient willingness to have the same surgery again, and it is achieved with low erosion rate.
authors.affiliation: Female Pelvic Medicine and Reconstructive Surgery Fellowship Program, Department of Obstetrics and Gynecology, Methodist Hospital of Indianapolis/Indiana University, 1633 North Capitol Avenue, Indianapolis, IN 46202, USA. k-su@sbcglobal.net
authors.forename: Kenneth C H
authors.initials: KC
authors.lastname: Su
authors.forename: Martina F
authors.initials: MF
authors.lastname: Mutone
authors.forename: Colin L
authors.initials: CL
authors.lastname: Terry
authors.forename: Douglass S
authors.initials: DS
authors.lastname: Hale
mesh_terms: D003094:Collagen / Q000627:therapeutic use; D005205:Fascia / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D010502:Perineum / Q000601:surgery; D011126:Polypropylenes; D011183:Postoperative Complications; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000523:psychology / Q000601:surgery; D014596:Uterine Prolapse / Q000523:psychology / Q000601:surgery*; D014621:Vagina / Q000601:surgery
chemical_list: D011126:Polypropylenes; D003094:Collagen