Long‐term quality of life outcomes and retreatment rates after robotic sacrocolpopexy

Linder, Brian J.; Chow, George K.; Elliott, Daniel S.

doi:10.1111/iju.12900

Cited by 22 publications

(13 citation statements)

References 20 publications

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“…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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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: 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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“…Editorial Comment from Dr Sakamoto to Risk of urinary stones among women with pelvic organ prolapse: A national population-based cohort study Chang et al described very novel evidence regarding the risk of urolithiasis that has never been previously reported. 1 Based on the longitudinal National Health Insurance Research Database including patient information from 1996 to 2013 in Taiwan, the author identified the possible link between pelvic organ prolapse (POP) and urolithiasis.…”

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confidence: 99%

“…POP is a common condition in older women . Nephrolithiasis has high prevalence rates in the global population .…”

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confidence: 99%

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POP is a common condition in older women. 1,2 Nephrolithiasis has high prevalence rates in the global population. 3 We aimed to estimate whether a higher prevalence of urinary tract stones in older women, except those caused by increased urinary calcium excretion, was associated with POP.The study used the National Health Insurance Research Database from 1996 to 2013.

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Risk of urinary stones among women with pelvic organ prolapse: A national population‐based cohort study

et al. 2018

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“…In the present article, Lindner et al . report on their single institutional, retrospective analysis of long‐term outcomes after robotic sacrocolpopexy . Approximately 90% of patients were free from repeat surgery at 6 years, and the 8.6% rate of recurrent prolapse requiring surgical intervention compares favorably with other series with shorter follow up .…”

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Editorial Comment to Long‐term quality of life outcomes and retreatment rates after robotic sacrocolpopexy

Halpern

Lee

2015

Int J of Urology

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In the present article, Lindner et al. report on their single institutional, retrospective analysis of long-term outcomes after robotic sacrocolpopexy. 1 Approximately 90% of patients were free from repeat surgery at 6 years, and the 8.6% rate of recurrent prolapse requiring surgical intervention compares favorably with other series with shorter follow up. 2 However, as the authors note, the retrospective nature and non-uniform follow up in the study could obscure true recurrence rates insofar as patients might have been lost to follow up, particularly at a tertiary care institution. Nevertheless, patientreported outcomes at a median of 90 months follow up showed high rates of satisfaction with a median 9 out of 10 score with regard to symptomatic improvement. The high rate of symptomatic improvement and low incidence of recurrent prolapse surgery suggest durability of treatment.The series also shows a relatively low rate of mesh complication with just two patients (2.7%) suffering vaginal mesh extrusion, comparable with other published series with shortand medium-term follow up. 3 Retroperitonealization of the polypropylene mesh and preservation of the cervix likely contribute to low rates of mesh complication. Given the recent controversy regarding use of mesh in transvaginal prolapse surgery, the low rate of mesh complication in this longterm follow-up series reaffirms the safety of mesh use in robotic sacrocolpopexy.It is important to note that the current study population was somewhat limited. No patients possessed a body mass index >30, just three patients (4.3%) were diabetic and two patients (2.9%) were smokers. Indeed, this patient population might not be representative of the typical index patient who undergoes robotic sacrocolpopexy, particularly given the associations between the aforementioned factors and pelvic organ prolapse. 4 Additionally, the authors excluded 14 patients (17%) who required conversion to open sacrocolpopexy; the results for these patients are reported elsewhere and are notable for a correlation between elevated body mass index and the need for conversion. 5 This relatively high rate of conversion relative to other published series suggests a need for continued careful patient selection and further investigation of risk factors for conversion. 3 Overall, robotic sacrocolpopexy is a highly safe and effective procedure for the treatment of apical prolapse. Despite its limitations, the current study adds to the growing body of literature in support of this procedure, and is among the first to show durability of treatment for the long-term follow-up period. References1 Linder BJ, Chow GK, Elliott DS. Long-term quality of life outcomes and retreatment rates after robotic sacrocolpopexy. Int. J. Urol. 2015; 22: 1155-8. 2 Germain A, Thibault F, Galifet M et al. Long-term outcomes after totally robotic sacrocolpopexy for treatment of pelvic organ prolapse. Surg. Endosc. 2013; 27: 525-9. 3 Lee RK, Mottrie A, Payne CK, Waltregny D. A review of the current status of laparoscopic and robot-as...

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Long‐term quality of life outcomes and retreatment rates after robotic sacrocolpopexy

Abstract: Robotic sacrocolpopexy is associated with excellent long-term outcomes. Recognition of long-term success is important for preoperative patient counseling.

Cited by 22 publications

References 20 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

Risk of urinary stones among women with pelvic organ prolapse: A national population‐based cohort study

Editorial Comment to Long‐term quality of life outcomes and retreatment rates after robotic sacrocolpopexy

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