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Route of Hysterectomy at the Time of Sacrocolpopexy: A Multicenter Retrospective Cohort Study.
Female Pelvic Med Reconstr Surg. 2022 02 01; 28(2):85-89.FP

Abstract

OBJECTIVES

This study aimed to compare the incidence of mesh exposure based on route of hysterectomy at the time of minimally invasive sacrocolpopexy. Secondary outcomes included perioperative outcomes and prolapse recurrence.

METHODS

This was a multicenter, retrospective cohort study. Patients who underwent sacrocolpopexy between 2007 and 2017 were stratified by hysterectomy approach: total vaginal hysterectomy (TVH), total laparoscopic or robotic hysterectomy (TLH), and laparoscopic or robotic supracervical hysterectomy (LSH). Total vaginal hysterectomy was subdivided into vaginal and laparoscopic mesh attachment to the cuff. Statistical analyses were performed, with P < 0.05 denoting statistical significance.

RESULTS

Seven institutions participated, and 502 minimally invasive sacrocolpopexies with concomitant hysterectomy were performed by 23 surgeons: 263 TVH, 128 TLH, and 111 LSH. The median follow-up interval was 10 months, and this was significantly different between the groups (months): TVH, 11 (3-13); TLH, 2 (2-9); and LSH, 12 (5-24; P < 0.01). The overall incidence of vaginal mesh exposure was 4.0% (20/502). There were no significant differences in vaginal mesh exposure based on hysterectomy route: TVH, 5.7% (15/263); TLH, 1.6% (2/128); and LSH, 2.7% (3/111; P = 0.11). Within the TVH group, there was no significant difference in vaginal mesh exposure comparing vaginal and laparoscopic mesh attachment: 1.9% (1/52) versus 6.6% (14/211; P = 0.48). Laparoscopic supracervical hysterectomy demonstrated a significantly higher incidence of recurrence compared with TVH and TLH: 10.8% (12/111) versus 3.4% (9/263) and 2.3% (3/128; P < 0.01).

CONCLUSIONS

The incidence of sacrocolpopexy mesh exposure was not significantly different based on route of hysterectomy or mode of mesh attachment to the vagina. There was a significant increase in prolapse recurrence with supracervical hysterectomy.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Gupta A
From the University of Louisville, Louisville, KY.
Ton JB
St Luke's University Health Network, Bethlehem, PA.
Maheshwari D
UMass-Baystate Medical Center, Springfield, MA.
Schroeder MN
Cooper University Hospital/Cooper Medical School of Rowan University, Camden, NJ.
Small AN
Las Vegas Minimally Invasive Surgery, Las Vegas, NV.
Jia X
No affiliation info available
Demtchouk VO
Mount Auburn Hospital, Cambridge, MA.
Hoke TP
University of Alabama at Birmingham, Birmingham, AL.
Murphy M
Institute for Female Pelvic Medicine, North Wales, PA.

MeSH

FemaleHumansHysterectomyHysterectomy, VaginalLaparoscopyPostoperative ComplicationsRetrospective StudiesSurgical MeshTreatment OutcomeVagina

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

34333501

Citation

Gupta, Ankita, et al. "Route of Hysterectomy at the Time of Sacrocolpopexy: a Multicenter Retrospective Cohort Study." Female Pelvic Medicine & Reconstructive Surgery, vol. 28, no. 2, 2022, pp. 85-89.
Gupta A, Ton JB, Maheshwari D, et al. Route of Hysterectomy at the Time of Sacrocolpopexy: A Multicenter Retrospective Cohort Study. Female Pelvic Med Reconstr Surg. 2022;28(2):85-89.
Gupta, A., Ton, J. B., Maheshwari, D., Schroeder, M. N., Small, A. N., Jia, X., Demtchouk, V. O., Hoke, T. P., & Murphy, M. (2022). Route of Hysterectomy at the Time of Sacrocolpopexy: A Multicenter Retrospective Cohort Study. Female Pelvic Medicine & Reconstructive Surgery, 28(2), 85-89. https://doi.org/10.1097/SPV.0000000000001087
Gupta A, et al. Route of Hysterectomy at the Time of Sacrocolpopexy: a Multicenter Retrospective Cohort Study. Female Pelvic Med Reconstr Surg. 2022 02 1;28(2):85-89. PubMed PMID: 34333501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Route of Hysterectomy at the Time of Sacrocolpopexy: A Multicenter Retrospective Cohort Study. AU - Gupta,Ankita, AU - Ton,Jessica B, AU - Maheshwari,Deepali, AU - Schroeder,Michelle N, AU - Small,Alyssa N, AU - Jia,Xibei, AU - Demtchouk,Veronica O, AU - Hoke,Tanya P, AU - Murphy,Miles, PY - 2021/8/2/pubmed PY - 2022/2/3/medline PY - 2021/8/1/entrez SP - 85 EP - 89 JF - Female pelvic medicine & reconstructive surgery JO - Female Pelvic Med Reconstr Surg VL - 28 IS - 2 N2 - OBJECTIVES: This study aimed to compare the incidence of mesh exposure based on route of hysterectomy at the time of minimally invasive sacrocolpopexy. Secondary outcomes included perioperative outcomes and prolapse recurrence. METHODS: This was a multicenter, retrospective cohort study. Patients who underwent sacrocolpopexy between 2007 and 2017 were stratified by hysterectomy approach: total vaginal hysterectomy (TVH), total laparoscopic or robotic hysterectomy (TLH), and laparoscopic or robotic supracervical hysterectomy (LSH). Total vaginal hysterectomy was subdivided into vaginal and laparoscopic mesh attachment to the cuff. Statistical analyses were performed, with P < 0.05 denoting statistical significance. RESULTS: Seven institutions participated, and 502 minimally invasive sacrocolpopexies with concomitant hysterectomy were performed by 23 surgeons: 263 TVH, 128 TLH, and 111 LSH. The median follow-up interval was 10 months, and this was significantly different between the groups (months): TVH, 11 (3-13); TLH, 2 (2-9); and LSH, 12 (5-24; P < 0.01). The overall incidence of vaginal mesh exposure was 4.0% (20/502). There were no significant differences in vaginal mesh exposure based on hysterectomy route: TVH, 5.7% (15/263); TLH, 1.6% (2/128); and LSH, 2.7% (3/111; P = 0.11). Within the TVH group, there was no significant difference in vaginal mesh exposure comparing vaginal and laparoscopic mesh attachment: 1.9% (1/52) versus 6.6% (14/211; P = 0.48). Laparoscopic supracervical hysterectomy demonstrated a significantly higher incidence of recurrence compared with TVH and TLH: 10.8% (12/111) versus 3.4% (9/263) and 2.3% (3/128; P < 0.01). CONCLUSIONS: The incidence of sacrocolpopexy mesh exposure was not significantly different based on route of hysterectomy or mode of mesh attachment to the vagina. There was a significant increase in prolapse recurrence with supracervical hysterectomy. SN - 2154-4212 UR - https://www.unboundmedicine.com/medline/citation/34333501/Route_of_Hysterectomy_at_the_Time_of_Sacrocolpopexy:_A_Multicenter_Retrospective_Cohort_Study_ DB - PRIME DP - Unbound Medicine ER -