Advanced Cystocele is a Risk Factor for Surgical Failure after Robotic-assisted Laparoscopic Sacrocolpopexy

Padoa, Anna; Shiber, Yair; Fligelman, Tal; Tomashev, Roni; Tsviban, Anna; Smorgick, Noam

doi:10.1016/j.jmig.2021.11.002

Cited by 12 publications

(13 citation statements)

References 33 publications

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“…Friedman et al and Padoa et al reported that a preoperative point Ba of being 3 cm or more was a risk factor for recurrence 29,30 . Our results were almost in agreement with this assertion.…”

Section: Discussionsupporting

confidence: 91%

“…Friedman et al and Padoa et al reported that a preoperative point Ba of being 3 cm or more was a risk factor for recurrence. 29,30 Our results were almost in agreement with this assertion. Takeyama et al reported that in young patients with advanced cystocele and uterine prolapse who underwent TVM surgery with a transobturator four-arm mesh similar to the Prolift type, the rate of recurrence was significantly higher than in older patients.…”

Section: Discussionsupporting

confidence: 90%

“…6 Padoa et al reported that in 52.2% of patients who underwent robot-assisted sacrocolpopexy for advanced cystocele, prolapse recurred. 30 TVM-A2 may be suitable for such cases, but the results may be the same even with a different technique. This issue remains to be resolved.…”

Section: Discussionmentioning

confidence: 99%

“…Takeyama et al reported that in young patients with advanced cystocele and uterine prolapse who underwent TVM surgery with a transobturator four‐arm mesh similar to the Prolift type, the rate of recurrence was significantly higher than in older patients 6 . Padoa et al reported that in 52.2% of patients who underwent robot‐assisted sacrocolpopexy for advanced cystocele, prolapse recurred 30 . TVM‐A2 may be suitable for such cases, but the results may be the same even with a different technique.…”

Section: Discussionmentioning

confidence: 99%

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Are anterior mesh arms necessary in Japanese‐style transvaginal mesh surgery for cystocele?

Watanabe

Takeyama

Kuwata

et al. 2022

J of Obstet and Gynaecol

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Aim In this study, we retrospectively analyzed the medium‐term efficacy and safety of surgery with transobturator two‐arm transvaginal mesh for cystocele and to verify whether the anterior arms are necessary for Japanese‐style transvaginal mesh surgery. Methods The study included 203 patients with cystocele who underwent transobturator two‐arm transvaginal mesh at our hospital between August 2015 and June 2017 and received appropriate follow‐up care for at least 48 months after surgery. Results The Pelvic Organ Prolapse Quantification stage was III in all the patients. Intraoperative complications included two cases of bladder injury and one case of more than 200 mL of blood loss. The mean observation period was 51.9 months, and prolapse recurred in the operated compartment in nine patients (4.4%). No cases of mesh exposure were observed. In comparing the preoperative characteristics of the 9 patients with prolapse recurrence at the surgical site with those of the other 194 patients, we found that the recurrence rate was significantly higher among patients in whom point Ba being 3.5 cm or more and among patients younger than 66 years. Conclusions Transobturator two‐arm transvaginal mesh for cystocele was as good and safe as the procedure previously reported with four‐arm mesh; thus, it was possible to omit the anterior mesh arms in Japanese‐style transvaginal mesh surgery. Patients should be informed preoperatively that prolapse recurs at a significantly higher rate among younger patients and in those whose point Ba being 3.5 cm or more.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Are anterior mesh arms necessary in Japanese‐style transvaginal mesh surgery for cystocele?

Watanabe

Takeyama

Kuwata

et al. 2022

J of Obstet and Gynaecol

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“…[5][6][7][8][9][10][11][12][13][14][15][16] Advanced preoperative anterior vaginal prolapse (AVP), need for concomitant apical repair at the time of SCP, and age are known risk factors for prolapse recurrence after SCP, but very few studies have investigated the effect of cervical preservation on prolapse recurrence. 17,18 Urogynecologists have increasingly transitioned to supracervical hysterectomy (SCH) over total hysterectomy (TH) at the time of SCP to prevent mesh erosion, but limited evidence suggests that cervical preservation may increase the risk of prolapse recurrence by 9-22%. [19][20][21][22][23] However, these studies have focused on overall failure rates, not compartment specific recurrence.…”

mentioning

confidence: 99%

Recurrence of Anterior Vaginal Prolapse After Robotic Sacrocolpopexy: Does Cervical Preservation Affect Outcome?

Eckhardt

Lee

Nguyen

2023

UROGC

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ImportanceAnterior vaginal prolapse (AVP) is the most common site of recurrence after sacrocolpopexy (SCP). Supracervical hysterectomy helps to prevent mesh exposure, but it is unclear if cervical preservation (CP) affects adequate reduction of AVP.ObjectiveOur primary objective was to determine the difference in AVP recurrence rates in patients who have undergone SCP with or without CP. Secondary outcomes were composite failure and complications rates.Study DesignThis was a retrospective cohort analysis of women who underwent robotic SCP between 2012 and 2019 at Kaiser Permanente Southern California. The first cohort included women with CP (prior or concomitant supracervical hysterectomy). The second included women without CP (prior or concomitant total hysterectomy). Primary outcome was defined as recurrent AVP beyond the hymen. Patients without 12-month follow-up were included in demographic and surgical data analysis only.ResultsThe charts of 373 patients with CP and 175 without CP were reviewed. Women with CP were more likely to undergo concomitant anterior repair at the time of SCP (14% vs 6%, P < 0.01); however, rates of AVP recurrence were not significantly different between groups (5% vs 3%, P = 0.26). Median follow-up time was 26 months (interquartile range, 14–38 months). Composite failure was similar between groups (17% vs 11%, P = 0.12). Women with CP were more likely to experience asymptomatic apical failure (6% vs 1%, P = 0.03).ConclusionsCervical preservation at the time of SCP is associated with an increased need for concomitant anterior repair but is not associated with higher rates of AVP recurrence or composite failure.

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Transvaginal Repair of Cystocele

Jen¹,

Novin²,

Ginsberg³

2022

Female Genitourinary and Pelvic Floor Reconstruction

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Advanced Cystocele is a Risk Factor for Surgical Failure after Robotic-assisted Laparoscopic Sacrocolpopexy

Cited by 12 publications

References 33 publications

Are anterior mesh arms necessary in Japanese‐style transvaginal mesh surgery for cystocele?

Are anterior mesh arms necessary in Japanese‐style transvaginal mesh surgery for cystocele?

Recurrence of Anterior Vaginal Prolapse After Robotic Sacrocolpopexy: Does Cervical Preservation Affect Outcome?

Transvaginal Repair of Cystocele

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