Transvaginal Versus Transabdominal Placement of Synthetic Mesh at Time of Sacrocolpopexy.

MedStar author(s):
Citation: Female Pelvic Medicine & Reconstructive Surgery. 22(3):151-5, 2016 May-JunPMID: 26571429Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology | Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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]Year: 2016ISSN:
  • 2151-8378
Name of journal: Female pelvic medicine & reconstructive surgeryAbstract: 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.All authors: Carter CM, Gutman RE, Iglesia CB, Nosti PA, Park AJ, Sokol AI, Tefera EFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2017-05-24
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Journal Article MedStar Authors Catalog Article 26571429 Available 26571429

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.

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