Mesh erosion in robotic sacrocolpopexy

Area of Science:

• Urogynecology
• Minimally Invasive Surgery
• Pelvic Reconstructive Surgery

Background:

• Robotic sacrocolpopexy is a surgical procedure to treat pelvic organ prolapse.
• Hysterectomy, the removal of the uterus, can be performed as a total hysterectomy (TH) or supracervical hysterectomy (SH).
• Mesh erosion is a known complication following sacrocolpopexy.

Purpose of the Study:

• To compare the incidence of mesh erosion after robotic sacrocolpopexy in women who underwent either total hysterectomy (TH) or supracervical hysterectomy (SH).

Main Methods:

• Retrospective cohort study involving 102 women undergoing robotic sacrocolpopexy and concomitant hysterectomy (May 2007-December 2010).
• Primary outcome: mesh erosion identified within 3 months post-surgery.
• Data collected included patient demographics, surgical details, and follow-up outcomes.

Main Results:

• Mesh erosion occurred in 8 women (all with TH), with an incidence of 14% in the TH group versus 0% in the SH group.
• Mesh erosion rates varied significantly between two surgical sites (37% vs. 3%), correlating with mesh type (self-cut vs. precut polypropylene).
• Two women in the SH group were diagnosed with abnormal uterine pathology.

Conclusions:

• Supracervical hysterectomy (SH) was associated with no mesh erosion within the first 3 months post-robotic sacrocolpopexy.
• Graft material may be a modifiable factor influencing mesh erosion in total hysterectomy (TH).
• Further investigation, including longer-term follow-up and randomized trials, is warranted. Abnormal uterine pathology is a possibility with SH.