Complications and reoperations after laparoscopic sacrocolpopexy with a mean follow-up of 4 years

Vandendriessche, David; Sussfeld, Julie; Giraudet, Géraldine; Lucot, Jean-Philippe; Behal, Hélène; Cosson, Michel

doi:10.1007/s00192-016-3093-6

Cited by 51 publications

(30 citation statements)

References 29 publications

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“…One of these six studies included 391 patients. The authors reported mesh-related complications requiring surgical intervention in 2.8% [51]. However, follow-up in this study, was carried out by telephone interview and the numbers could therefore be underestimated.…”

Section: Overview Of Literaturementioning

confidence: 70%

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Long-term mesh erosion rate following abdominal robotic reconstructive pelvic floor surgery: a prospective study and overview of the literature

et al. 2019

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Introduction and hypothesis The use of synthetic mesh in transvaginal pelvic floor surgery has been subject to debate internationally.Although mesh erosion appears to be less associated with an abdominal approach, the long-term outcome has not been studied intensively. This study was set up to determine the long-term mesh erosion rate following abdominal pelvic reconstructive surgery. Methods A prospective, observational cohort study was conducted in a tertiary care setting. All consecutive female patients who underwent robot-assisted laparoscopic sacrocolpopexy and sacrocolporectopexy in 2011 and 2012 were included. Primary outcome was mesh erosion. Preoperative and postoperative evaluation (6 weeks, 1 year, 5 years) with a clinical examination and questionnaire regarding pelvic floor symptoms was performed. Mesh-related complications were assessed using a transparent vaginal speculum, proctoscopy, and digital vaginal and rectal examination. Kaplan-Meier estimates were calculated for mesh erosion. A review of the literature on mesh exposure after minimally invasive sacrocolpopexy was performed (≥12 months' follow-up).Results Ninety-six of the 130 patients included (73.8%) were clinically examined. Median follow-up time was 48.1 months (range 36.0-62.1). Three mesh erosions were diagnosed (3.1%; Kaplan-Meier 4.9%, 95% confidence interval 0-11.0): one bladder erosion for which mesh resection and an omental patch interposition were performed, and two asymptomatic vaginal erosions (at 42.7 and 42.3 months) treated with estrogen cream in one. Additionally, 22 patients responded solely by questionnaire and/or telephone; none reported mesh-related complaints. The literature, mostly based on retrospective studies, described a median mesh erosion rate of 1.9% (range 0-13.3%). Conclusions The long-term rate of mesh erosion following an abdominally placed synthetic graft is low.

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Section: Overview Of Literaturementioning

confidence: 70%

“…Eighty-three percent of the articles reported an erosion percentage of ≤5% with an overall median erosion rate of 1.9%. Six studies (9.2%) had a follow-up duration of more than 48 months [24,34,43,51,61,74]. One of these six studies included 391 patients.…”

Section: Overview Of Literaturementioning

confidence: 99%

Long-term mesh erosion rate following abdominal robotic reconstructive pelvic floor surgery: a prospective study and overview of the literature

et al. 2019

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“…Vandendriessche et al . reported that uterine preservation could be a risk factor for recurrence of cystocele after LSC . At the same time, they also showed that subtotal hysterectomy has a protective effect against recurrence of cystocele.…”

Section: Resultsmentioning

confidence: 90%

“…This may be especially true in cases in which uterus preservation procedures were completed. However, subtotal hysterectomy may mitigate this risk and reduce the likelihood of recurrence .…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic versus abdominal sacrocolpopexy for treatment of multi‐compartmental pelvic organ prolapse: A systematic review

Ichikawa

Kaseki

Akira

2018

Asian J Endoscop Surgery

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Laparoscopic sacrocolpopexy (LSC) is attracting increasing attention as a minimally invasive surgery that provides excellent therapeutic effects on apical vaginal prolapse. However, its therapeutic effects on multi-compartmental pelvic organ prolapse (POP) remain unclear. Therefore, the aim of this review was to evaluate the efficacy of LSC on multi-compartmental POP compared with abdominal sacrocolpopexy (ASC). We extracted three articles on randomized controlled trials that compared LSC and ASC. A total of 247 patients (123 for LSC, 124 for ASC) were evaluated. There was no evidence of recurrence or reoperation in either group for the apical vaginal compartment. Regarding recurrence within the anterior vaginal compartment, there were no significant between-group differences in either of the two randomized controlled trials targeting vaginal vault prolapse. In contrast, in the randomized controlled trial targeting POP including cases with uteruses, there were more recurrent POP with grade II or more in the LSC group than in the ASC group (11/60 [18.3%] vs 1/60 [1.6%], P = 0.004). Reoperation for the posterior vaginal compartment was performed in three cases (2.5%) in the LSC group and in one case (0.8%) in the ASC group. The combined repeat surgery and mesh removal surgery rate was higher in the LSC group (8/119 [6.7%]) than in the ASC group (2/121 [1.7%], P = 0.049). LSC has an excellent therapeutic effect and is comparable to ASC for the treatment of apical prolapse. However, cystocele recurrence, repeat surgery of the posterior compartment, and mesh-related complications were more frequent in patients who had undergone LSC.

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“…However, sacrocolpopexy presents technical difficulties with a long learning curve and high risk during the procedure . Since exposing anterior longitudinal ligament is an inevitable step during the sacrocolpopexy, the procedure usually causes various certain deficiencies, including intrusion to the area of retroperitoneal nerve plexuses, the risks of vascular complications and nonphysiological placement .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic inguinal ligament suspension combined with hysterectomy for the treatment of uterovaginal prolapse

Dai

Shu

2019

J of Obstet and Gynaecol

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Aim: To demonstrate the efficacy and safety of a modified technique of laparoscopic inguinal ligament suspension (LILS) with hysterectomy for the treatment of uterovaginal prolapse. Methods: A total of 57 patients were treated by LILS combined with hysterectomy between Jan 2014 and Feb 2016. The perioperative parameters, such as operative time, estimated blood loss, length of stay and intra-and postoperative complications were recorded. The Pelvic Organ Prolapse questionnaire classification was applied to evaluate the Pelvic Organ Prolapse stage, and Patient Global Impression of Improvement scale was used to determine the patients' satisfaction. Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire were used to evaluate the functional improvement. All data were collected preoperatively and then at 12 months postoperatively. Results: The mean surgical time was 130.4 (82-190) min, the average blood loss was 50.4 (10-300) mL and the mean hospitalization was 5.3 (4-8) days. The rates of intra-and postoperative complications were low. After a minimal of 12 months follow-up, the anatomical success rate was 85.5%, and the subjective satisfaction rate was 92.7%. The functional measures also presented a significant improvement with no recurrence of prolapse. Conclusion: LILS combined with hysterectomy was a safe and effective technique and might be considered as an alternative treatment for patients with uterovaginal prolapse.

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Complications and reoperations after laparoscopic sacrocolpopexy with a mean follow-up of 4 years

Abstract: Prolapse recurrence and mesh-related surgery occurred in 5.1 and 2.8 % of patients respectively, 4 years after laparoscopic sacrocolpopexy. Age and concomitant subtotal hysterectomy could play a role in the incidence of long-term reoperation.

Cited by 51 publications

References 29 publications

Long-term mesh erosion rate following abdominal robotic reconstructive pelvic floor surgery: a prospective study and overview of the literature

Long-term mesh erosion rate following abdominal robotic reconstructive pelvic floor surgery: a prospective study and overview of the literature

Laparoscopic versus abdominal sacrocolpopexy for treatment of multi‐compartmental pelvic organ prolapse: A systematic review

Laparoscopic inguinal ligament suspension combined with hysterectomy for the treatment of uterovaginal prolapse

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