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Mesh erosion in robotic sacrocolpopexy.
Female Pelvic Med Reconstr Surg. 2012 Mar-Apr; 18(2):86-8.FP

Abstract

OBJECTIVE

This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH).

METHODS

This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery. The primary outcome was mesh erosion identified during 3 months of follow-up.

RESULTS

A total of 102 women underwent sacrocolpopexy, of whom 45 were with concomitant SH and 57 were with total hysterectomy (TH). Their mean age was 58 years, mean body mass index was 26.8 kg/m, 98% were white, 6% smoked, and 25% were on systemic hormone replacement therapy. Mean preoperative Ba = +1.4, C = -2.2. These were not different between the 2 groups or by site. Within 3 months of surgery, mesh erosion was diagnosed in 8 women, all of whom had TH. No mesh erosions occurred in the SH group (14% vs 0%). Total hysterectomy mesh erosion rate at site 1 was 37% compared with 3% [corrected] at site 2. Mesh type was the only identifiable difference between sites: self-cut polypropylene at site 1, precut polypropylene at site 2. Two women in the SH had abnormal uterine pathology: 1 endometrial adenocarcinoma and 1 focus of hyperplasia with atypia.

CONCLUSIONS

No mesh erosions were associated with SH within the first 3 months. In TH, the graft material used may be a modifiable factor needing further investigation. Unexpected abnormal uterine pathologic diagnosis remains a possibility with SH. Longer-term follow-up and a randomized trial are warranted to answer these questions.

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Authors+Show Affiliations

Osmundsen BC
Oregon Health & Science University, Portland, OR, USA. Blake.Osmundsen@Providence.org
Clark A
No affiliation info available
Goldsmith C
No affiliation info available
Adams K
No affiliation info available
Denman MA
No affiliation info available
Edwards R
No affiliation info available
Gregory WT
No affiliation info available

MeSH

Equipment Failure AnalysisFemaleHumansHysterectomyMiddle AgedOutcome and Process Assessment, Health CarePolypropylenesPostoperative ComplicationsPractice Patterns, Physicians'Retrospective StudiesRisk FactorsSurgical MeshSuture TechniquesTime FactorsUterine Prolapse

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22453317

Citation

Osmundsen, Blake C., et al. "Mesh Erosion in Robotic Sacrocolpopexy." Female Pelvic Medicine & Reconstructive Surgery, vol. 18, no. 2, 2012, pp. 86-8.
Osmundsen BC, Clark A, Goldsmith C, et al. Mesh erosion in robotic sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2012;18(2):86-8.
Osmundsen, B. C., Clark, A., Goldsmith, C., Adams, K., Denman, M. A., Edwards, R., & Gregory, W. T. (2012). Mesh erosion in robotic sacrocolpopexy. Female Pelvic Medicine & Reconstructive Surgery, 18(2), 86-8. https://doi.org/10.1097/SPV.0b013e318246806d
Osmundsen BC, et al. Mesh Erosion in Robotic Sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2012 Mar-Apr;18(2):86-8. PubMed PMID: 22453317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mesh erosion in robotic sacrocolpopexy. AU - Osmundsen,Blake C, AU - Clark,Amanda, AU - Goldsmith,Crystal, AU - Adams,Kerrie, AU - Denman,Mary Anna, AU - Edwards,Renee, AU - Gregory,William Thomas, PY - 2012/3/29/entrez PY - 2012/3/29/pubmed PY - 2012/5/9/medline SP - 86 EP - 8 JF - Female pelvic medicine & reconstructive surgery JO - Female Pelvic Med Reconstr Surg VL - 18 IS - 2 N2 - OBJECTIVE: This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH). METHODS: This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery. The primary outcome was mesh erosion identified during 3 months of follow-up. RESULTS: A total of 102 women underwent sacrocolpopexy, of whom 45 were with concomitant SH and 57 were with total hysterectomy (TH). Their mean age was 58 years, mean body mass index was 26.8 kg/m, 98% were white, 6% smoked, and 25% were on systemic hormone replacement therapy. Mean preoperative Ba = +1.4, C = -2.2. These were not different between the 2 groups or by site. Within 3 months of surgery, mesh erosion was diagnosed in 8 women, all of whom had TH. No mesh erosions occurred in the SH group (14% vs 0%). Total hysterectomy mesh erosion rate at site 1 was 37% compared with 3% [corrected] at site 2. Mesh type was the only identifiable difference between sites: self-cut polypropylene at site 1, precut polypropylene at site 2. Two women in the SH had abnormal uterine pathology: 1 endometrial adenocarcinoma and 1 focus of hyperplasia with atypia. CONCLUSIONS: No mesh erosions were associated with SH within the first 3 months. In TH, the graft material used may be a modifiable factor needing further investigation. Unexpected abnormal uterine pathologic diagnosis remains a possibility with SH. Longer-term follow-up and a randomized trial are warranted to answer these questions. SN - 2151-8378 UR - https://www.unboundmedicine.com/medline/citation/22453317/Mesh_erosion_in_robotic_sacrocolpopexy_ L2 - https://doi.org/10.1097/SPV.0b013e318246806d DB - PRIME DP - Unbound Medicine ER -