title: Mesh erosion in robotic sacrocolpopexy.
abstract: OBJECTIVE
  This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH).
  
  
  METHODS
  This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery. The primary outcome was mesh erosion identified during 3 months of follow-up.
  
  
  RESULTS
  A total of 102 women underwent sacrocolpopexy, of whom 45 were with concomitant SH and 57 were with total hysterectomy (TH). Their mean age was 58 years, mean body mass index was 26.8 kg/m, 98% were white, 6% smoked, and 25% were on systemic hormone replacement therapy. Mean preoperative Ba = +1.4, C = -2.2. These were not different between the 2 groups or by site. Within 3 months of surgery, mesh erosion was diagnosed in 8 women, all of whom had TH. No mesh erosions occurred in the SH group (14% vs 0%). Total hysterectomy mesh erosion rate at site 1 was 37% compared with 3% [corrected] at site 2. Mesh type was the only identifiable difference between sites: self-cut polypropylene at site 1, precut polypropylene at site 2. Two women in the SH had abnormal uterine pathology: 1 endometrial adenocarcinoma and 1 focus of hyperplasia with atypia.
  
  
  CONCLUSIONS
  No mesh erosions were associated with SH within the first 3 months. In TH, the graft material used may be a modifiable factor needing further investigation. Unexpected abnormal uterine pathologic diagnosis remains a possibility with SH. Longer-term follow-up and a randomized trial are warranted to answer these questions.
authors.affiliation: Oregon Health & Science University, Portland, OR, USA. Blake.Osmundsen@Providence.org
authors.forename: Blake C
authors.initials: BC
authors.lastname: Osmundsen
authors.forename: Amanda
authors.initials: A
authors.lastname: Clark
authors.forename: Crystal
authors.initials: C
authors.lastname: Goldsmith
authors.forename: Kerrie
authors.initials: K
authors.lastname: Adams
authors.forename: Mary Anna
authors.initials: MA
authors.lastname: Denman
authors.forename: Renee
authors.initials: R
authors.lastname: Edwards
authors.forename: William Thomas
authors.initials: WT
authors.lastname: Gregory
mesh_terms: D019544:Equipment Failure Analysis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011126:Polypropylenes / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects*; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation; D013997:Time Factors; D014596:Uterine Prolapse / Q000601:surgery*
chemical_list: D011126:Polypropylenes