Transvaginal Versus Transabdominal Placement of Synthetic Mesh at Time of Sacrocolpopexy

Nosti, Patrick A.; Carter, Charelle M.; Sokol, Andrew I.; Tefera, Eshetu; Iglesia, Cheryl B.; Park, Amy J.; Gutman, Robert E.

doi:10.1097/spv.0000000000000222

Cited by 30 publications

(35 citation statements)

References 20 publications

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“…It has been suggested that, this rate was significantly increased in cases of abdominal sacrocolpopexy with vaginal placement of the mesh (40%) . However, no evidence of infection was observed by the present study and other authors that have used a transvaginal route for the mesh placement. Erosion may be the result of an inflammatory reaction because of infection of the mesh or, possibly, because of an immunological response to the graft or suture material.…”

Section: Discussioncontrasting

confidence: 55%

Pre‐ and postoperative magnetic resonance imaging (MRI) findings in patients treated with laparoscopic sacrocolpopexy. Is it a safe procedure for all patients?

Zacharakis

Grigoriadis

Bourgioti³

et al. 2017

Neurourology and Urodynamics

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Introduction Laparoscopic sacrocolpopexy (LSCP) is a reference operation for apical compartment prolapse repair. Aim of this study is to describe the early and midterm postoperative MRI findings of the lumbosacral region (LSR) in patients undergoing LSCP and to detect any imaging changes that the presence of the mesh may cause on patients with preexisting degenerative disease of the LSR. Methods Patients with POP‐Q grade III and IV uterovaginal or vaginal vault prolapse who were considered eligible for LSCP were invited to participate. An MRI of the LSR was performed preoperatively and then 3 and 12 months postoperatively. Patients with vaginal vault prolapse underwent LSCP, while women with uterovaginal prolapse were treated with the vaginally assisted laparoscopic sacrocolpopexy (VALS). Results A total of 30 patients were included in the study; 18 (60%) underwent LSCP and 12 (40%) VALS. On preoperative MRIs, 83.3% (25/30) of patients had degenerative changes and 70% (21/30) reported having low back pain (LBP). Postoperative MRIs did not reveal any imaging changes compared to the preoperative MRI findings both for patients with or without preexisting degenerative abnormalities of the LSR. No significant changes in the LBP score were observed postoperatively. Conclusions Any bone marrow or soft‐tissue changes at MRIs of the LSR early after the insertion of a synthetic mesh, does not constitute an expected postoperative finding and should raise the suspicion of an ongoing inflammatory or infectious spinal process (spondylodiscitis). Additionally, LSCP seems to be a safe surgical approach for women with preexisting degenerative disease of the LSR.

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Section: Discussioncontrasting

confidence: 55%

Pre‐ and postoperative magnetic resonance imaging (MRI) findings in patients treated with laparoscopic sacrocolpopexy. Is it a safe procedure for all patients?

Zacharakis

Grigoriadis

Bourgioti³

et al. 2017

Neurourology and Urodynamics

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show abstract

“…Nosti et al [14] reported mesh-related complication rates of 1.6% versus 1.7% associated with total vaginal hysterectomy-LSC and LSH (laparoscopic supraservical hysterectomy)-LSC respectively. In the total vaginal hysterectomy-LSC cohort (n 5 123), the technique describes a combined vaginal-laparoscopic approach.…”

Section: Discussionmentioning

confidence: 99%

Vaginal Sacral Colpopexy: A Natural Orifice Approach to a Gold Standard Procedure

Hanes

2018

Journal of Minimally Invasive Gynecology

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In this small pilot study, a transvaginal retroperitoneal sacral colpopexy is described and is demonstrated to be feasible and safe. Based on the experience gained, changes in technique have been implemented to prevent future mechanical tack failures. Assuming that these changes will be successful in preventing apical recurrence due to dislodgement of mesh from the anterior longitudinal ligament, a larger study is planned to determine efficacy. Inherent advantages of the transvaginal approach are discussed, including a favorable morbidity profile, full access to all compartments, short operating times, and decreased costs.

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“…In our cohort, we noted a significant increase in vaginal hysterectomies. The change to this practice pattern should not be surprising: uterovaginal prolapse lends itself to this modality, and available studies at that time demonstrated that vaginal hysterectomy at the time of sacrocolpopexy did not seem to affect prolapse recurrence [10,23]. This practice pattern change was shortlived, however, as our data demonstrated a significant resurgence in laparoscopic-assisted supracervical hysterectomy within 2 years of the morcellator being banned but with permanent adoption of contained tissue extraction in a bag.…”

Section: Figmentioning

confidence: 63%

Occult Uterine Malignancy at the Time of Sacrocolpopexy in the Context of the Safety Communication on Power Morcellation by the FDA

Chang

Ferrando

2021

Journal of Minimally Invasive Gynecology

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Transvaginal Versus Transabdominal Placement of Synthetic Mesh at Time of Sacrocolpopexy

Cited by 30 publications

References 20 publications

Pre‐ and postoperative magnetic resonance imaging (MRI) findings in patients treated with laparoscopic sacrocolpopexy. Is it a safe procedure for all patients?

Pre‐ and postoperative magnetic resonance imaging (MRI) findings in patients treated with laparoscopic sacrocolpopexy. Is it a safe procedure for all patients?

Vaginal Sacral Colpopexy: A Natural Orifice Approach to a Gold Standard Procedure

Occult Uterine Malignancy at the Time of Sacrocolpopexy in the Context of the Safety Communication on Power Morcellation by the FDA

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