Assessing the Impact of Vaginal Hysterectomy with Vaginal Mesh Attachment on Outcomes and Complications During Minimally Invasive Sacrocolpopexy.

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Citation: Journal of Minimally Invasive Gynecology. 2022 Oct 09PMID: 36223863Institution: MedStar Washington Hospital CenterDepartment: Female Pelvic Medicine & Reconstructive Surgery Fellowship | Obstetrics & Gynecology Residency | Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022ISSN:
  • 1553-4650
Name of journal: Journal of minimally invasive gynecologyAbstract: CONCLUSIONS: Total vaginal hysterectomy with vaginal mesh attachment of ultra-lightweight mesh had similar adverse events, mesh exposure rates and failure rates to laparoscopic post-hysterectomy sacrocolpopexy or supracervical hysterectomy with laparoscopic mesh attachment. Copyright © 2022. Published by Elsevier Inc.DESIGN: Single center retrospective cohort study SETTING: Tertiary referral center PATIENTS: Women with symptomatic pelvic organ prolapse who elected for minimally invasive sacrocolpopexy INTERVENTIONS: Laparoscopic minimally invasive sacrocolpopexy with ultra-lightweight mesh attached vaginally during total vaginal hysterectomy, laparoscopically if post-hysterectomy or laparoscopically during supracervical hysterectomy. Composite failure was defined as recurrent prolapse symptoms, prolapse past the hymen, or retreatment for prolapse.MEASUREMENTS AND MAIN RESULTS: Between 2010 and 2017, 650 patients met inclusion criteria with 278 post-hysterectomy, 82 supracervical hysterectomy and 290 vaginal hysterectomy patients. Median follow up was similar for all groups (382 days vs 379 vs 345, p=0.31). The majority in all groups were white (66.6%), non-smokers (74.8%), postmenopausal (82.5%) and did not use estrogen (70.3%). Mesh complications did not differ between groups (1.6% post-hysterectomy, 2.5% supracervical hysterectomy, 2.2% vaginal hysterectomy, p>0.99). There was no difference in anatomic failure (5% post-hysterectomy, 1.2% supracervical hysterectomy, 2.1% vaginal hysterectomy, p=0.07), reoperation for prolapse (1.4% vs 1.2% vs 0.7%, p=0.57) or composite failure (9.0% vs 3.7% vs 4.8%, p=0.07).STUDY OBJECTIVES: To compare mesh complications and failure rates after 1 year in laparoscopic minimally invasive sacrocolpopexy with ultra-lightweight mesh attached vaginally during total vaginal hysterectomy, laparoscopically if post-hysterectomy or laparoscopically during supracervical hysterectomy.All authors: Bradley SE, Clarke B, Gutman RE, Schirm KA, Sokol AI, Ward SA, Woodburn KLFiscal year: FY2023Digital Object Identifier: Date added to catalog: 2022-10-27
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Journal Article MedStar Authors Catalog Article 36223863 Available 36223863

CONCLUSIONS: Total vaginal hysterectomy with vaginal mesh attachment of ultra-lightweight mesh had similar adverse events, mesh exposure rates and failure rates to laparoscopic post-hysterectomy sacrocolpopexy or supracervical hysterectomy with laparoscopic mesh attachment. Copyright © 2022. Published by Elsevier Inc.

DESIGN: Single center retrospective cohort study SETTING: Tertiary referral center PATIENTS: Women with symptomatic pelvic organ prolapse who elected for minimally invasive sacrocolpopexy INTERVENTIONS: Laparoscopic minimally invasive sacrocolpopexy with ultra-lightweight mesh attached vaginally during total vaginal hysterectomy, laparoscopically if post-hysterectomy or laparoscopically during supracervical hysterectomy. Composite failure was defined as recurrent prolapse symptoms, prolapse past the hymen, or retreatment for prolapse.

MEASUREMENTS AND MAIN RESULTS: Between 2010 and 2017, 650 patients met inclusion criteria with 278 post-hysterectomy, 82 supracervical hysterectomy and 290 vaginal hysterectomy patients. Median follow up was similar for all groups (382 days vs 379 vs 345, p=0.31). The majority in all groups were white (66.6%), non-smokers (74.8%), postmenopausal (82.5%) and did not use estrogen (70.3%). Mesh complications did not differ between groups (1.6% post-hysterectomy, 2.5% supracervical hysterectomy, 2.2% vaginal hysterectomy, p>0.99). There was no difference in anatomic failure (5% post-hysterectomy, 1.2% supracervical hysterectomy, 2.1% vaginal hysterectomy, p=0.07), reoperation for prolapse (1.4% vs 1.2% vs 0.7%, p=0.57) or composite failure (9.0% vs 3.7% vs 4.8%, p=0.07).

STUDY OBJECTIVES: To compare mesh complications and failure rates after 1 year in laparoscopic minimally invasive sacrocolpopexy with ultra-lightweight mesh attached vaginally during total vaginal hysterectomy, laparoscopically if post-hysterectomy or laparoscopically during supracervical hysterectomy.

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