Objective
To evaluate the safety and short-term efficacy of complete sacrocolpopexy mesh excision
with concomitant autologous fascia sacrocolpopexy.
Methods
A retrospective cohort study of patients undergoing complete sacrocolpopexy mesh excision
and concomitant autologous fascia sacrocolpopexy from March 2013 to September 2016
was conducted. The primary objective was assessment of perioperative outcomes including
complications within 60 days of surgery. The secondary outcome measure was surgical
success defined as no need for retreatment by either surgery for apical prolapse or
pessary.
Results
Nineteen patients were identified. Median patient age was 56 years old (range 35-78).
Median time from mesh placement to surgical excision was 4.5 years (0-13). Indications
for mesh excision included refractory pelvic pain in 18 patients (95%), symptomatic
mesh exposure in 8 patients (42%), and bilateral ureteral obstruction with ureterovaginal
fistula in 1 patient (5%). Median operative time, estimated blood loss, and length
of hospital stay were 228 minutes (133-362), 200 mL (50-1000), and 5 days (2-9), respectively.
The rate of minor and major complications within 60 days was 36.8% and 5.3%, respectively.
There were no cases of bladder or bowel injury. At a median follow-up of 9.9 months
(2.4-39) no patient required secondary surgery for apical vaginal prolapse or retreatment
with pessary.
Conclusion
Complete sacrocolpopexy mesh excision with concomitant autologous fascia sacrocolpopexy
can be accomplished safely with a low rate of major complications. These are short-term
findings and longer follow-up of anatomic and functional outcomes is needed.
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Article info
Publication history
Published online: May 04, 2017
Accepted:
April 27,
2017
Received:
February 26,
2017
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
