Risk factors for mesh/suture erosion following sacral colpopexy.
OBJECTIVE
The purpose of this study was to identify risks for mesh/suture erosions following abdominal sacral colpopexy (ASC).


METHODS
We analyzed demographic, perioperative variables, and erosion status in 322 participants in the Colpopexy and Urinary Reduction Efforts study 2 years after sacral colpopexy.


RESULTS
The predominant graft used was synthetic mesh: woven polyester (Mersilene; Ethicon, Inc, Somerville, NJ) (42%) or polypropylene (48%). Twenty subjects (6%) experienced mesh/suture erosion. Unadjusted risk factors for mesh/suture erosion were expanded polytrafluroethylene (ePTFE) mesh (ePTFE 4/21 [19%] vs non-ePTFE 16/301 [5%]; odds ratio [OR], 4.2), concurrent hysterectomy (OR, 4.9), and current smoking (OR, 5.2). Of those with mesh erosion, most affected women (13/17) underwent at least 1 surgery for partial or total mesh removal. Two were completely resolved, 6 had persistent problems, and 5 were lost to follow-up. No resolution was documented in the 4 women who elected observation.


CONCLUSIONS
Expanded PTFE mesh should not be used for sacral colpopexy. Concurrent hysterectomy and smoking are modifiable risks for mesh/suture erosion.
Cundiff
Geoffrey W
GW
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada.
Varner
Edward
E
Visco
Anthony G
AG
Zyczynski
Halina M
HM
Nager
Charles W
CW
Norton
Peggy A
PA
Schaffer
Joseph
J
Brown
Morton B
MB
Brubaker
Linda
L
D000328:Adult; D000368:Aged; D003127:Colposcopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012307:Risk Factors; D012720:Severity of Illness Index; D013526:Surgical Mesh / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014596:Uterine Prolapse / Q000150:complications / Q000175:diagnosis / Q000601:surgery*