Mesh erosion following abdominal sacral colpopexy in the absence and presence of the cervical stump.
OBJECTIVE
We compared the role of abdominal sacral colpopexy (ASCP) with concomitant supracervical hysterectomy to ASCP alone in patients with prior hysterectomy in the prevention of mesh erosion.


METHODS
We performed a retrospective chart review of 277 consecutive patients who underwent ASCP with one surgeon. Patients were separated into two groups based on the presence of a uterus at the time of surgery. Group A comprised195 patients with a uterus who underwent ASCP and concomitant supracervical hysterectomy; group B comprised 82 patients with prior total hysterectomy who underwent ASCP. The outcome measures included peri- and postoperative findings, complications, and surgical success. Data were analyzed by t test and chi-square test using SPSS software.


RESULTS
No significant difference was found between groups during surgery in terms of anesthesia type, total operative time, and estimated intraoperative blood loss. At mean postoperative follow-up of 7-8 months, there was no difference between groups in terms of de novo urinary symptoms, recurrent vaginal-wall prolapse, or dyspareunia and Pelvic Organ Prolapse Quantification (POP-Q) point C examination. Sling erosion was observed in four (4.2 %) patients in group A versus none in group B. Apical mesh erosion was diagnosed in one patient in group A (0.5 %) and two (2.4 %) patients in group B. These differences were not statistically significant.


CONCLUSIONS
Concomitant supracervical hysterectomy with ASCP was associated with a low incidence of mesh erosion and had the same intraoperative course and postoperative outcome as ASCP with previous hysterectomy.
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA. ginath@gmail.com
Shimon
S
Ginath
Alan D
AD
Garely
Alexander
A
Condrea
Michael D
MD
Vardy
D016009:Chi-Square Distribution; D003127:Colposcopy / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D016015:Logistic Models; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome