Anterior Bilateral Sacrospinous Fixation With Transvaginal Mesh: Is Hysterectomy a Risk Factor for Complications?
Female Pelvic Med Reconstr Surg
; 27(10): 616-620, 2021 10 01.
Article
in En
| MEDLINE
| ID: mdl-33411457
ABSTRACT
OBJECTIVES:
The aim of the study was to evaluate the effect of hysterectomy on the risk of complications from transvaginal pelvic organ prolapse surgery with mesh.METHODS:
We conducted a retrospective cohort study between October 2010 and December 2017. Transvaginal mesh surgery was performed in patients with symptomatic anterior and/or apical prolapse (Pelvic Organ Prolapse Quantification ≥ stage 2). The primary outcome was rate of severe surgical complications based on the Clavien-Dindo classification (defined as grade ≥3), and the secondary outcome was the anatomical success at the last postoperative follow-up visit.RESULTS:
Three hundred and ninety-six patients were included, 289 of these patients underwent anterior sacrospinous fixation with uterine preservation, 50 had a previous hysterectomy and 57 underwent a concomitant hysterectomy. The median follow-up was 12 months (interquartile range, 7 months). The rate of severe complications was 2.1%, 6.0%, and 5.3% in the uterine preservation group, previous hysterectomy group, and concomitant hysterectomy group, respectively (P = 0.2). The operative time was significantly higher in the concomitant hysterectomy group, and the mesh exposure rate was significantly higher in the previous hysterectomy group. The overall recurrence rate was 7.6%, with no differences between the study groups.CONCLUSIONS:
Concomitant and previous hysterectomy did not appear to increase the severe complication rate or anatomical failure after transvaginal mesh surgery. However, a history of hysterectomy appears to be a risk factor for vaginal mesh exposure. This must be considered in the choice between prosthetic and autologous management options for the treatment of posthysterectomy vault prolapse.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgical Mesh
/
Pelvic Organ Prolapse
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
Language:
En
Journal:
Female Pelvic Med Reconstr Surg
Year:
2021
Document type:
Article
Affiliation country:
France