title: Are women with advanced pelvic organ prolapse treated by open mesh sacrocolpopexy at risk of secondary incisional hernia?
abstract: BACKGROUND
  Our purpose was to determine whether vaginal hernia is a predisposing factor for incisional hernia (IH) in a cohort of women with symptomatic pelvic organ prolapse (POP) who underwent corrective repair by open mesh sacrocolpopexy (MSC) and had long-term follow-up to determine their rate of subsequent IH.
  
  
  METHODS
  Following IRB approval, the charts of women entered into a longitudinal database and who underwent open MSC at a tertiary institution were reviewed. Data collected included demographics, MSC and IH details, and long-term outcome. Patients were excluded if the follow-up after MSC was < 1 year. Data were reviewed by a neutral investigator who was not involved in patient care (FA).
  
  
  RESULTS
  From 1999 to 2012, 75 of 88 women met inclusion criteria, with mean follow-up of 65 (48-84) months. Thirteen were either lost to follow-up or had follow-up < 1 year. Seven women underwent symptomatic IH repair, with a mean onset of IH diagnosis after MSC at 18 (range 8-72) months. Five repairs were done via an open approach, and two were repaired laparoscopically. No IH recurrence was noted at a mean of 41 (range 14-75) months after IH repair. No risk factors were identified in the IH group compared with those who did not form a secondary IH.
  
  
  CONCLUSIONS
  In this longitudinal series, IH after open MSC occurred in 9.3%, a rate comparable with that reported in women undergoing abdominal procedures through midline or Pfannenstiel incisions.
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Feras
authors.initials: F
authors.lastname: Alhalabi
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Chasta D
authors.initials: CD
authors.lastname: Bacsu
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Omer
authors.initials: O
authors.lastname: Gulpinar
authors.affiliation: Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Scott
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA. Philippe.zimmern@utsouthwestern.edu.|UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9110, USA. Philippe.zimmern@utsouthwestern.edu.
authors.forename: Philippe E
authors.initials: PE
authors.lastname: Zimmern
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D000069290:Incisional Hernia / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D014623:Vaginal Diseases / Q000453:epidemiology / Q000209:etiology*
keywords: Cystocele; Mesh sacrocolpopexy; Pelvic prolapse; Recurrence; Suprapubic incisional hernia