Original articleRisk of Mesh Extrusion and Other Mesh-Related Complications After Laparoscopic Sacral Colpopexy with or without Concurrent Laparoscopic-Assisted Vaginal Hysterectomy: Experience of 402 Patients
Section snippets
Study Design
After receiving institutional review board approval, a historical cohort analysis of office and hospital records was performed for all patients who underwent laparoscopic sacral colpopexy from January 2003 through January 2007 at our institution. In all, 446 consecutive patients with uterovaginal or vaginal vault prolapse were treated with laparoscopic sacral colpopexy in conjunction with other laparoscopic and/or vaginal procedures. Data were collected in the form of chart reviews and patient
Results
Records were reviewed for 402 patients meeting study criteria. In all, 130 patients with concurrent hysterectomy and 272 patients with a previous hysterectomy were followed up postoperatively for 1 to 54 months. The demographic data, including age, ethnicity, gravidity and parity, weight, largest birth weight inclusive of deliveries via cesarean section, and estrogen-containing preparation use, are shown in Table 1. Data comparing patients’ surgical history in each group are provided in Table 2.
Discussion
Multiple procedures for uterovaginal and vaginal vault prolapse have been successfully performed laparoscopically. Recently conducted comparative cohort analysis indicated the comparable aspects of laparoscopic and open abdominal approaches to sacral colpopexy with respect to clinical outcomes and safety whereas the laparoscopic approach offers the benefits of minimally invasive surgery [17]. In addition to providing minimally invasive access to the peritoneal cavity [18], the laparoscopic
Conclusion
The risks of mesh-related complications associated with laparoscopic sacral colpopexy were low and equal to about 1% for mesh extrusions, infection, reaction, and apical pain. We believe that low risk of mesh-related complications is the result of use of macroporous soft knitted polypropylene mesh and strict adherence to surgical techniques indicated to decrease the risk of mesh exposure and other mesh-related complications.
No statistically significant differences in mesh-related complication
Acknowledgment
We would like to thank Dawn Blackhurst, PhD, for her statistical analysis of this study.
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