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A comparative study of laparoscopic sacrocolpopexy and total vaginal mesh procedure using lightweight polypropylene meshes for prolapse repair.

Abstract：

OBJECTIVE:Use of vaginal meshes for treatment of pelvic organ prolapse (POP) remains controversial. A trend toward abdominal approaches and the development of new meshes has been noted. We compared the 1-year results of two different approaches using new lightweight meshes. MATERIALS AND METHODS:Sixty-nine (95.8%) of 72 women with POP Stage ≥ 2, who underwent laparoscopic sacrocolpopexy (LSC) (n = 39) or a total vaginal mesh (TVM) procedure (n = 30) using lightweight polypropylene meshes, were studied. Baseline and follow-up assessments included a pelvic examination and a composite condition-specific questionnaire. A detailed comparison of 1-year outcomes was made. Data were analyzed using appropriate statistical methods. RESULTS:Compared to the TVM group, the LSC group was characterized by a younger age (53.7 years vs. 64.1 years, p < 0.001) and a longer operating time (264 minutes vs. 177.6 minutes, p < 0.001). Objective anatomic success (POP Stage ≤ 1) rates were similar between groups after statistical adjustment, i.e., 84.6% (33/39) and 86.7% (26/30) after LSC and TVM (p = 0.94), respectively. However, the dominant recurrence sites were different with anterior (n = 6) most frequent after LSC and apical (n = 4) most frequent after TVM. Reoperations were needed for the four (13.3%) apical recurrences in the TVM group. No serious complications were noted. We found "cystocele as the dominant prolapse" (p = 0.016; odds ratio = 6.94) and "suspension of prolapsed (POP Stage ≥ 2) uterus" (p = 0.025; odds ratio = 7.00) significantly affected recurrence after LSC and TVM, respectively. CONCLUSION:POP repair by LSC or TVM using the new lightweight polypropylene meshes seems to be safe and has comparable outcomes, but limitations may vary.

journal_name

Taiwan J Obstet Gynecol

journal_title

Taiwanese journal of obstetrics & gynecology

authors

Liu CK,Tsai CP,Chou MM,Shen PS,Chen GD,Hung YC,Hung MJ

doi

10.1016/j.tjog.2014.07.006

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

552-8

issue

eissn

1028-4559

issn

1875-6263

pii

S1028-4559(14)00188-0

journal_volume

pub_type

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A comparative study of laparoscopic sacrocolpopexy and total vaginal mesh procedure using lightweight polypropylene meshes for prolapse repair.