title: A comparative study of laparoscopic sacrocolpopexy and total vaginal mesh procedure using lightweight polypropylene meshes for prolapse repair.
abstract: OBJECTIVE
  Use of vaginal meshes for treatment of pelvic organ prolapse (POP) remains controversial. A trend toward abdominal approaches and the development of new meshes has been noted. We compared the 1-year results of two different approaches using new lightweight meshes.
  
  
  METHODS
  Sixty-nine (95.8%) of 72 women with POP Stage ≥ 2, who underwent laparoscopic sacrocolpopexy (LSC) (n = 39) or a total vaginal mesh (TVM) procedure (n = 30) using lightweight polypropylene meshes, were studied. Baseline and follow-up assessments included a pelvic examination and a composite condition-specific questionnaire. A detailed comparison of 1-year outcomes was made. Data were analyzed using appropriate statistical methods.
  
  
  RESULTS
  Compared to the TVM group, the LSC group was characterized by a younger age (53.7 years vs. 64.1 years, p < 0.001) and a longer operating time (264 minutes vs. 177.6 minutes, p < 0.001). Objective anatomic success (POP Stage ≤ 1) rates were similar between groups after statistical adjustment, i.e., 84.6% (33/39) and 86.7% (26/30) after LSC and TVM (p = 0.94), respectively. However, the dominant recurrence sites were different with anterior (n = 6) most frequent after LSC and apical (n = 4) most frequent after TVM. Reoperations were needed for the four (13.3%) apical recurrences in the TVM group. No serious complications were noted. We found "cystocele as the dominant prolapse" (p = 0.016; odds ratio = 6.94) and "suspension of prolapsed (POP Stage ≥ 2) uterus" (p = 0.025; odds ratio = 7.00) significantly affected recurrence after LSC and TVM, respectively.
  
  
  CONCLUSIONS
  POP repair by LSC or TVM using the new lightweight polypropylene meshes seems to be safe and has comparable outcomes, but limitations may vary.
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chih-Ku
authors.initials: CK
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Ching-Pei
authors.initials: CP
authors.lastname: Tsai
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Min-Min
authors.initials: MM
authors.lastname: Chou
authors.affiliation: Department of Statistics, Tunghai University, Taichung, Taiwan.
authors.forename: Pao-Sheng
authors.initials: PS
authors.lastname: Shen
authors.affiliation: Department of Obstetrics and Gynecology, Chung Shan Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Gin-Den
authors.initials: GD
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, China Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Yao-Ching
authors.initials: YC
authors.lastname: Hung
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University School of Medicine, Taichung, Taiwan; Department of Obstetrics and Gynecology, China Medical University School of Medicine, Taichung, Taiwan. Electronic address: mjhung@vghtc.gov.tw.
authors.forename: Man-Jung
authors.initials: MJ
authors.lastname: Hung
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011126:Polypropylenes; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*
chemical_list: D011126:Polypropylenes
keywords: lightweight polypropylene mesh; pelvic organ prolapse; sacrocolpopexy; total vaginal mesh