title: Laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse after failed transvaginal polypropylene mesh surgery.
abstract: OBJECTIVE
  A prospective case series to assess the safety and efficacy of laparoscopic sacrocolpopexy for the surgical management of recurrent pelvic organ prolapse (POP) after transvaginal polypropylene mesh prolapse surgery.
  
  
  METHODS
  Between January and December 2010, women with post-hysterectomy recurrent prolapse (≥ stage 2 POP-Q) after transvaginal polypropylene mesh prolapse surgery were included. Perioperative morbidity and short-term complications were recorded and evaluated. Surgical outcomes were objectively assessed utilising the Pelvic Organ Prolapse Quantification system (POP-Q), the validated, condition-specific Australian Pelvic Floor Questionnaire (APFQ) and the Patient Global Impression of Improvement (PGI-I) at 12 months.
  
  
  RESULTS
  All 16 women in this study had undergone surgery with trocar-guided transvaginal polypropylene mesh kits. In 75% the recurrent prolapse affected the compartment of prior mesh surgery with the anterior (81%) and apical (75%) compartment prolapse predominating. At a mean follow-up of 12 months, all women had resolution of awareness of prolapse, had < stage 2 POP-Q on examination and high levels of satisfaction on PGI-I post surgery. There were no serious peri- or postoperative complications.
  
  
  CONCLUSIONS
  This preliminary study suggests that laparoscopic sacrocolpopexy for recurrent prolapse after failed transvaginal mesh surgery is feasible and safe. Further widespread evaluation is required.
authors.affiliation: Urogynaecology, Royal Brisbane & Women's Hospital, Butterfield Street, Herston, Brisbane, QLD, 4029, Australia. cocoschmid@hotmail.com
authors.forename: Corina
authors.initials: C
authors.lastname: Schmid
authors.forename: Peter
authors.initials: P
authors.lastname: O'Rourke
authors.forename: Christopher
authors.initials: C
authors.lastname: Maher
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh; D017211:Treatment Failure