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International Urogynecology Journal

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01-04-2021 | Sacrocolpopexy | Original Article

Long-term safety and efficacy of laparoscopically placed mesh for apical prolapse

Authors: Gemma Nightingale, Christian Phillips

Published in: International Urogynecology Journal | Issue 4/2021

Abstract

Introduction and hypothesis

Concerns regarding the use of vaginal mesh for prolapse have led to questions about the safety and efficacy of abdominally placed mesh. Mesh procedures for treating apical prolapse have become popular, either a laparoscopic hysteropexy (LSH) for uterine prolapse or a sacrocolpopexy (LSC) for vaginal vault prolapse. Robust long-term safety and efficacy data for these procedures are essential.

Methods

All patients who had LSH or LSC since 2010 were invited back for face-to-face review and examination. Case notes were reviewed for surgical morbidities and patients were questioned about short- and long-term complications. The Patient Global Impression of Improvement (PGI-I) scale was used to assess prolapse, bladder and bowel symptoms postoperatively.

Results

One hundred twelve patients were included in the review, 93 of whom were examined. The median time since surgery was 6 years (range 1–9 years); 2.7% cases had an intraoperative complication, two conversions to laparotomy and one bladder injury. Overall, 17.3% patients sought medical review postoperatively, with 10.7% having problems with their skin incisions. With regard to mesh safety, there was one case of bowel obstruction requiring resection following LSH and two vaginal mesh exposures following LSC; 97% had stage 1 or less apical prolapse at long-term follow-up and 79.6% reported symptoms of prolapse to be ‘much better’ or ‘very much better’ on the PGI-I scale.

Conclusions

This study shows excellent long-term results from LSC and LSH with comprehensive follow-up, demonstrating a very low and acceptable level of intraoperative, short- and long-term complications.

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Title: Long-term safety and efficacy of laparoscopically placed mesh for apical prolapse
Authors: Gemma Nightingale
Christian Phillips
Publication date: 01-04-2021
Publisher: Springer International Publishing
Keyword: Sacrocolpopexy
Published in: International Urogynecology Journal / Issue 4/2021
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-020-04374-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term safety and efficacy of laparoscopically placed mesh for apical prolapse

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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