Long-term mesh exposure after minimally invasive total hysterectomy and sacrocolpopexy

Catherine A. Matthews, Erinn M. Myers, Barbara R. Henley, Kimberly Kenton, Erica Weaver, Jennifer M. Wu, Elizabeth J. Geller

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction and hypothesis: The objective was to evaluate total and incident mesh exposure rates at least 2 years after minimally invasive total hysterectomy and sacrocolpopexy. Secondary aims were to evaluate surgical success and late adverse events. Methods: This extension study included women previously enrolled in the multicenter randomized trial of permanent vs delayed-absorbable suture with lightweight mesh for > stage II uterovaginal prolapse. Owing to COVID-19, women were given the option of an in-person (questionnaires and examination) or telephone visit (questionnaires only). The primary outcome was total and incident suture or mesh exposure, or symptoms suggestive of mesh exposure in women without an examination. Secondary outcomes were surgical success, which was defined as no subjective bulge, no prolapse beyond the hymen, and no pelvic organ prolapse retreatment, and adverse events. Results: A total of 182 out of 200 previously randomized participants were eligible for inclusion, of whom 106 (58%) women (78 in-person and 28 via questionnaire only) agreed to the extension study. At a mean of 3.9 years post-surgery, the rate of mesh or suture exposure was 7.7% (14 out of 182) of whom only 2 were incident cases reported after 1-year follow-up. None reported vaginal bleeding or discharge, dyspareunia, or penile dyspareunia. Surgical success was 93 out of 106 (87.7%): 13 out of 94 (13.8%) failed by bulge symptoms, 2 out of 78 (2.6%) by prolapse beyond the hymen, 1 out of 85 (1.2%) by retreatment with pessary, and 0 by retreatment with surgery. There were no serious adverse events. Conclusions: The rate of incident mesh exposure between 1 and 3.9 years post-surgery was low, success rates remained high, and there were no delayed serious adverse events.

Original languageEnglish (US)
Pages (from-to)291-296
Number of pages6
JournalInternational Urogynecology Journal
Volume34
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • Mesh exposure
  • Outcomes
  • Sacrocolpopexy
  • Total hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Urology

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