Transvaginal Versus Transabdominal Placement of Synthetic Mesh at Time of Sacrocolpopexy.
Transvaginal Versus Transabdominal Placement of Synthetic Mesh at Time of Sacrocolpopexy.
- 2016
CONCLUSIONS: There was no difference in mesh-related complications between groups (1.6% TVH-LSC vs 1.7% LSH-LSC; P = 1.0). Vaginal mesh attachment during TVH-LSC decreased operative time by over 1 hour with no differences in intraoperative complications, reoperation for recurrent prolapse, and subjective or objective outcomes compared to LSH-LSC. METHODS: We performed a retrospective cohort study with prospective follow-up for patients with uterovaginal prolapse who underwent TVH-LSC or LSH-LSC from June 2008 to July 2012. We collected baseline demographics, mesh-related complications, intraoperative and postoperative complications, and pelvic organ prolapse quantification data. We contacted patients postoperatively for telephone interviews and to request a return to the office for repeat examination. OBJECTIVES: Our primary aim was to compare mesh-related complications at the time of total vaginal hysterectomy with laparoscopic sacrocolpopexy (TVH-LSC) versus laparoscopic placement of sacrocolpopexy mesh at time of laparoscopic supracervical hysterectomy (LSH-LSC). Our secondary aim was to compare operative time, intraoperative and postoperative complications, as well as subjective and objective success between these groups. RESULTS: One hundred eighty-two patients were included: 123 TVH-LSC and 59 LSH-LSC. There was no difference in the rate of mesh-related complications (1.6% [2/123]; 95% confidence interval, 0-3.86% vs 1.7% [1/59]; 95% confidence interval, 0-4.99%; P = 1.0). Median examination follow-up was similar between groups (9 (2-17) months TVH-LSC vs 9 (2-17) months LSH-LSC, P = 1.0).The TVH-LSC was associated with a significantly shorter operative time (256 +/- 53 vs 344 +/- 81 minutes; P < 0.01). There were no differences in intraoperative or postoperative complications or subjective and objective success between groups.
English
2151-8378
*Hysterectomy, Vaginal/mt [Methods]
*Pelvic Organ Prolapse/su [Surgery]
*Surgical Mesh/ae [Adverse Effects]
Adult
Aged
Female
Follow-Up Studies
Humans
Intraoperative Complications
Laparoscopy
Middle Aged
Operative Time
Postoperative Complications
Postoperative Period
Prospective Studies
Retrospective Studies
Risk Factors
Vagina/su [Surgery]
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology
Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
Journal Article
CONCLUSIONS: There was no difference in mesh-related complications between groups (1.6% TVH-LSC vs 1.7% LSH-LSC; P = 1.0). Vaginal mesh attachment during TVH-LSC decreased operative time by over 1 hour with no differences in intraoperative complications, reoperation for recurrent prolapse, and subjective or objective outcomes compared to LSH-LSC. METHODS: We performed a retrospective cohort study with prospective follow-up for patients with uterovaginal prolapse who underwent TVH-LSC or LSH-LSC from June 2008 to July 2012. We collected baseline demographics, mesh-related complications, intraoperative and postoperative complications, and pelvic organ prolapse quantification data. We contacted patients postoperatively for telephone interviews and to request a return to the office for repeat examination. OBJECTIVES: Our primary aim was to compare mesh-related complications at the time of total vaginal hysterectomy with laparoscopic sacrocolpopexy (TVH-LSC) versus laparoscopic placement of sacrocolpopexy mesh at time of laparoscopic supracervical hysterectomy (LSH-LSC). Our secondary aim was to compare operative time, intraoperative and postoperative complications, as well as subjective and objective success between these groups. RESULTS: One hundred eighty-two patients were included: 123 TVH-LSC and 59 LSH-LSC. There was no difference in the rate of mesh-related complications (1.6% [2/123]; 95% confidence interval, 0-3.86% vs 1.7% [1/59]; 95% confidence interval, 0-4.99%; P = 1.0). Median examination follow-up was similar between groups (9 (2-17) months TVH-LSC vs 9 (2-17) months LSH-LSC, P = 1.0).The TVH-LSC was associated with a significantly shorter operative time (256 +/- 53 vs 344 +/- 81 minutes; P < 0.01). There were no differences in intraoperative or postoperative complications or subjective and objective success between groups.
English
2151-8378
*Hysterectomy, Vaginal/mt [Methods]
*Pelvic Organ Prolapse/su [Surgery]
*Surgical Mesh/ae [Adverse Effects]
Adult
Aged
Female
Follow-Up Studies
Humans
Intraoperative Complications
Laparoscopy
Middle Aged
Operative Time
Postoperative Complications
Postoperative Period
Prospective Studies
Retrospective Studies
Risk Factors
Vagina/su [Surgery]
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology
Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery
Journal Article