title: Sacral colpopexy versus transvaginal mesh colpopexy in obese patients.
abstract: OBJECTIVE
  Obesity can predispose women to pelvic organ prolapse and can also affect the success of pelvic organ prolapse surgery. The purpose of this study was to compare the postoperative anatomical outcomes following sacral colpopexy (SC) and transvaginal mesh colpopexy in a group of obese women with pelvic organ prolapse.
  
  
  METHODS
  We conducted a retrospective cohort study of obese women who underwent SC (n = 56) or transvaginal mesh colpopexy (n = 35). Follow-up ranged from 6 to 12 months. Preoperative, perioperative, and postoperative variables were compared using Student t, Mann-Whitney U, and Fisher exact tests, and by analysis of covariance.
  
  
  RESULTS
  The women in the SC group had significantly higher mean apical vaginal measurements (P < 0.05), and significantly fewer stage II recurrences than women in the transvaginal mesh colpopexy group. There were no significant differences between the groups for other postoperative outcomes, including mesh erosion, recurrent prolapse symptoms, dyspareunia, and surgical satisfaction (P > 0.05).
  
  
  CONCLUSIONS
  In these 91 obese patients with pelvic organ prolapse, SC resulted in better anatomical outcomes than transvaginal mesh colpopexy. However, the two procedures had similar outcomes with regard to recurrent symptoms and surgical satisfaction.
authors.affiliation: Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto, Toronto ON.
authors.forename: Colleen D
authors.initials: CD
authors.lastname: McDermott
authors.affiliation: Urogynecology and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente, Fontana CA.
authors.forename: Jean
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Biostatistics, Methodist Hospital/Indiana University Health, Indianapolis IN.
authors.forename: Colin L
authors.initials: CL
authors.lastname: Terry
authors.affiliation: Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Methodist Hospital/Indiana University Health, Indianapolis IN.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Woodman
authors.affiliation: Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Methodist Hospital/Indiana University Health, Indianapolis IN.
authors.forename: Douglass S
authors.initials: DS
authors.lastname: Hale
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012447:Sacrum; D053825:Suburethral Slings; D013526:Surgical Mesh
keywords: Prolift; mesh; obese; prolapse; sacral colpopexy