Abdominal sacrocolpopexy for vault prolapse without burial of mesh: a case series

BJOG. 2005 Apr;112(4):486-9. doi: 10.1111/j.1471-0528.2004.00426.x.

Abstract

Objectives: To audit the clinical outcome of abdominal vault suspension (sacrocolpopexy, hysteropexy or cervicopexy) using non-absorbable mesh, without burial by closure of the peritoneum.

Design: A case series.

Setting: Urogynaecology units of four hospitals.

Population: One hundred and twenty-eight women having open or laparoscopic sacrocolpopexy (121), hysteropexy (6) or cervicopexy (1) using non-absorbable mesh for vault prolapse.

Methods: Patients had suspension of the vault, uterus or cervix from the sacral promontory using a monofilament polypropylene mesh. The pelvic peritoneum was not closed over the mesh. Patients were followed up every six months.

Main outcome measures: Incidence of bowel complications as a consequence of the mesh; cure rate of prolapse and incidence of other post-operative complications; rate of re-operation for prolapse or incontinence.

Result: After a median follow up of 19 months (1.5-62), there were no bowel complications as a result of non-burial of mesh. Three patients had asymptomatic vaginal mesh erosion, which required minor surgical intervention. Ninety percent of patients had good resolution of their prolapse symptoms while 10% of patients required further surgery.

Conclusion: Leaving the mesh uncovered by the pelvic peritoneum was not associated with complications. It appears safe to perform vault suspension without closing the peritoneum.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Colpotomy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Polypropylenes / therapeutic use*
  • Sacrococcygeal Region / surgery
  • Surgical Mesh*
  • Treatment Outcome
  • Uterine Prolapse / surgery*

Substances

  • Polypropylenes