Mesh Exposure After Robot-Assisted Laparoscopic Pelvic Floor Surgery: A Prospective Cohort Study

Femke van Zanten*, Jan J. van Iersel, Francis E. Hartog, Karin I.M. Aalders, Egbert Lenters, Ivo A.M.J. Broeders, Steven E. Schraffordt Koops

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

Study Objective: To prospectively evaluate the mesh exposure rate after robot-assisted laparoscopic pelvic floor surgery for the treatment of female pelvic organ prolapse (POP) in a large cohort. Design: Prospective observational cohort study (Canadian Task Force classification II-2). Setting: Two large teaching hospitals with a tertiary referral function for pelvic floor disorders. Patients: Patients with symptomatic POP and simplified POP quantification (S-POP) stage ≥2. Patients with a history of mesh repair or concomitant insertion of a tension-free vaginal tape were excluded. Interventions: Robot-assisted laparoscopic sacrocolpopexy or robot-assisted laparoscopic supracervical hysterectomy with a sacrocervicopexy. Measurements and Main Results: A blinded vaginal examination with the aid of a transparent speculum was performed to look for mesh-related complications. Mesh exposures were described following the International Urogynecological Association/International Continence Society classification system. One hundred and ninety-two patients were included, of whom 166 (86.5%) were seen for follow-up examination. The median duration of follow-up was 15.7 months (range, 8.2–44.4 months). Two vaginal mesh exposures (1.2%) were detected, both of which were treated in the outpatient clinic. One patient without any complaints had a suture exposure, which was removed in the outpatient clinic. Conclusion: The safety of the use of mesh in pelvic floor surgery is a matter of debate owing to the occurrence of mesh-related complications. Based on the current literature, mesh-related complications seem to be lower in transabdominal mesh surgery than in transvaginal mesh surgery. In this study, a low mesh exposure rate was observed in robot-assisted abdominal pelvic floor surgery for POP.

Original languageEnglish
Pages (from-to)636-642
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume26
Issue number4
DOIs
Publication statusPublished - 1 May 2019

Keywords

  • Mesh erosion
  • Pelvic organ prolapse
  • Sacrocervicopexy
  • Sacrocolpopexy

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