TY - JOUR T1 - What to Do With Recurrent Prolapse After Vaginal Mesh Failure? AU - Norinho de Oliveira,Paula, AU - Bourdel,Nicolas, AU - Rabischong,Benoit, AU - Canis,Michel, AU - Botchorishvili,Revaz, Y1 - 2015/09/25/ PY - 2015/06/21/received PY - 2015/09/10/revised PY - 2015/09/12/accepted PY - 2015/9/27/entrez PY - 2015/9/27/pubmed PY - 2016/7/30/medline KW - Laparoscopy KW - Mesh dissection KW - Sacrocolpopexy SP - 161 EP - 2 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 23 IS - 2 N2 - STUDY OBJECTIVE: To show that in selected cases laparoscopic sacrocolpopexy can be used for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery. METHODS: Step-by-step examination of the technique using an educative video. Institutional review board approval was obtained. SETTING: The authors describe two clinical cases of treatment of recurrent pelvic organ prolapse, after a vaginal mesh surgery, using laparoscopic sacrocolpopexy. PATIENTS: A 56-year old patient (para 3, gravida 2) presented with the sentation of bulging in the vagina. On physical examination, the patient had a grade 2-3 vaginal apical prolapse and a stage 4 rectocele. She had a slight mesh contraction but no vaginal extrusion and no pain were reported. Eleven years before, she had a vaginal total hysterectomy for pelvic organ prolapse correction and one year before she had a vaginal prolapse repair using a synthetic mesh. A laparoscopic sacrocolpopexy with bilateral ooforectomy was performed. The second case is of a 54-year old patient (para 2, gravida 2) that presented stress urinary incontinence. On physical examination, the patient had a grade 3 uterine prolapse and grade 2 cystocele. Eleven years before she had a vaginal prolapse repair using a synthetic mesh and a miduretral sling for stress urinary incontinence. Two years before, she had the miduretal sling removed for recurrent urinary infections and dysuria. A laparoscopic sub-total hysterectomy with salpingectomy and ovarian conservation, sacrocolpopexy and a Burch colposuspension was performed. MEASUREMENTS AND MAIN RESULTS: The procedures and postoperative recovery were uneventful. No minor or major complications occurred. The patients were discharged three days after surgery. CONCLUSION: Laparoscopic sacrocolpopexy is a promising approach for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery. It appears to be feasible, safe, and effective. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/26408228/What_to_Do_With_Recurrent_Prolapse_After_Vaginal_Mesh_Failure DB - PRIME DP - Unbound Medicine ER -