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Assessing the Impact of Vaginal Hysterectomy with Vaginal Mesh Attachment on Outcomes and Complications during Minimally Invasive Sacrocolpopexy.
J Minim Invasive Gynecol. 2023 01; 30(1):25-31.JM

Abstract

STUDY OBJECTIVE

To compare mesh complications and failure rates after 1 year in laparoscopic minimally invasive sacrocolpopexy (MISC) with ultralightweight mesh attached vaginally during total vaginal hysterectomy (TVH), laparoscopically if posthysterectomy (PH), or laparoscopically during supracervical hysterectomy.

DESIGN

Single-center retrospective cohort study.

SETTING

Tertiary referral center.

PATIENTS

Women with symptomatic pelvic organ prolapse who elected for MISC.

INTERVENTIONS

Laparoscopic MISC with ultralightweight mesh attached vaginally during TVH, laparoscopically if PH, or laparoscopically during supracervical hysterectomy. Composite failure was defined as recurrent prolapse symptoms, prolapse past the hymen, or retreatment for prolapse.

MEASUREMENTS AND MAIN RESULTS

Between 2010 and 2017, 650 patients met the inclusion criteria with 278 PH, 82 supracervical hysterectomy, and 290 vaginal hysterectomy patients. Median follow-up was similar for all groups (382 days vs 379 vs 345; p = .31). The majority in all groups were white (66.6%), nonsmokers (74.8%), postmenopausal (82.5%), and did not use estrogen (70.3%). Mesh complications did not differ among groups (1.6% PH, 2.5% supracervical hysterectomy, 2.2% vaginal hysterectomy; p >.99). There was no difference in anatomic failure (5% PH, 1.2% supracervical hysterectomy, 2.1% vaginal hysterectomy; p = .07), reoperation for prolapse (1.4% vs 1.2% vs 0.7%; p = .57), or composite failure (9.0% vs 3.7% vs 4.8%; p = .07).

CONCLUSIONS

TVH with vaginal mesh attachment of ultralightweight mesh had similar adverse events, mesh exposure rates, and failure rates to those of laparoscopic PH sacrocolpopexy or supracervical hysterectomy with laparoscopic mesh attachment.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Woodburn KL
Section of Female Pelvic Medicine and Reconstructive Surgery. Electronic address: kwoodburn19@gmail.com.
Bradley SE
Section of Female Pelvic Medicine and Reconstructive Surgery; Georgetown University/MedStar Washington Hospital Center, Washington, District of Columbia, Mission Health, Asheville, North Carolina; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts.
Ward SA
Department of Obstetrics and Gynecology; Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, Massachusetts.
Schirm KA
Department of Obstetrics and Gynecology.
Clarke B
Section of Female Pelvic Medicine and Reconstructive Surgery.
Gutman RE
Section of Female Pelvic Medicine and Reconstructive Surgery.
Sokol AI
Section of Female Pelvic Medicine and Reconstructive Surgery.

MeSH

HumansFemaleHysterectomy, VaginalSurgical MeshRetrospective StudiesVaginaPelvic Organ ProlapseHysterectomyLaparoscopyTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36223863

Citation

Woodburn, Katherine L., et al. "Assessing the Impact of Vaginal Hysterectomy With Vaginal Mesh Attachment On Outcomes and Complications During Minimally Invasive Sacrocolpopexy." Journal of Minimally Invasive Gynecology, vol. 30, no. 1, 2023, pp. 25-31.
Woodburn KL, Bradley SE, Ward SA, et al. Assessing the Impact of Vaginal Hysterectomy with Vaginal Mesh Attachment on Outcomes and Complications during Minimally Invasive Sacrocolpopexy. J Minim Invasive Gynecol. 2023;30(1):25-31.
Woodburn, K. L., Bradley, S. E., Ward, S. A., Schirm, K. A., Clarke, B., Gutman, R. E., & Sokol, A. I. (2023). Assessing the Impact of Vaginal Hysterectomy with Vaginal Mesh Attachment on Outcomes and Complications during Minimally Invasive Sacrocolpopexy. Journal of Minimally Invasive Gynecology, 30(1), 25-31. https://doi.org/10.1016/j.jmig.2022.09.556
Woodburn KL, et al. Assessing the Impact of Vaginal Hysterectomy With Vaginal Mesh Attachment On Outcomes and Complications During Minimally Invasive Sacrocolpopexy. J Minim Invasive Gynecol. 2023;30(1):25-31. PubMed PMID: 36223863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessing the Impact of Vaginal Hysterectomy with Vaginal Mesh Attachment on Outcomes and Complications during Minimally Invasive Sacrocolpopexy. AU - Woodburn,Katherine L, AU - Bradley,Sarah E, AU - Ward,Sarah A, AU - Schirm,Karen A, AU - Clarke,Bayley, AU - Gutman,Robert E, AU - Sokol,Andrew I, Y1 - 2022/10/09/ PY - 2022/06/27/received PY - 2022/09/21/revised PY - 2022/09/30/accepted PY - 2022/10/13/pubmed PY - 2023/1/11/medline PY - 2022/10/12/entrez KW - Mesh complication KW - Minimally invasive sacrocolpopexy KW - Pelvic organ prolapse KW - Vaginal hysterectomy SP - 25 EP - 31 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 30 IS - 1 N2 - STUDY OBJECTIVE: To compare mesh complications and failure rates after 1 year in laparoscopic minimally invasive sacrocolpopexy (MISC) with ultralightweight mesh attached vaginally during total vaginal hysterectomy (TVH), laparoscopically if posthysterectomy (PH), or laparoscopically during supracervical hysterectomy. DESIGN: Single-center retrospective cohort study. SETTING: Tertiary referral center. PATIENTS: Women with symptomatic pelvic organ prolapse who elected for MISC. INTERVENTIONS: Laparoscopic MISC with ultralightweight mesh attached vaginally during TVH, laparoscopically if PH, or laparoscopically during supracervical hysterectomy. Composite failure was defined as recurrent prolapse symptoms, prolapse past the hymen, or retreatment for prolapse. MEASUREMENTS AND MAIN RESULTS: Between 2010 and 2017, 650 patients met the inclusion criteria with 278 PH, 82 supracervical hysterectomy, and 290 vaginal hysterectomy patients. Median follow-up was similar for all groups (382 days vs 379 vs 345; p = .31). The majority in all groups were white (66.6%), nonsmokers (74.8%), postmenopausal (82.5%), and did not use estrogen (70.3%). Mesh complications did not differ among groups (1.6% PH, 2.5% supracervical hysterectomy, 2.2% vaginal hysterectomy; p >.99). There was no difference in anatomic failure (5% PH, 1.2% supracervical hysterectomy, 2.1% vaginal hysterectomy; p = .07), reoperation for prolapse (1.4% vs 1.2% vs 0.7%; p = .57), or composite failure (9.0% vs 3.7% vs 4.8%; p = .07). CONCLUSIONS: TVH with vaginal mesh attachment of ultralightweight mesh had similar adverse events, mesh exposure rates, and failure rates to those of laparoscopic PH sacrocolpopexy or supracervical hysterectomy with laparoscopic mesh attachment. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/36223863/Assessing_the_Impact_of_Vaginal_Hysterectomy_with_Vaginal_Mesh_Attachment_on_Outcomes_and_Complications_during_Minimally_Invasive_Sacrocolpopexy_ DB - PRIME DP - Unbound Medicine ER -