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Updated: Apr 30, 2026
Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
Published on: September 13, 2022
Additional surgical risk factors and patient characteristics for mesh erosion after abdominal sacrocolpopexy
Alpaslan Akyol1, Aysu Akca, Volkan Ulker
1Department of Obstetrics and Gynecology, Firat University Faculty of Medicine, Elazig, Turkey.
Aim:
The aim of this study is to determine the risk factors of mesh exposures following abdominal sacral colpopexy (ASC) in which polypropylene mesh is used.
Methods:
This is a retrospective cohort study of patients who underwent ASC and were subsequently followed for development of mesh exposure for vaginal/vault prolapse between 2002 and 2012. Demographics and risk factors of the patients who did develop mesh exposure after ASC and the ones who did not were compared.
Results:
In 42 months of survey, 19 of the 292 patients who underwent ASC developed mesh exposure. It was found that rates of patients with stage 3-4 prolapse were significantly greater in the mesh exposure group than in the control group (P = 0.04). Rates of mesh exposure were lower in patients with previous hysterectomy (P = 0.03). Also, it was found that concomitant hysterectomy or three or more additional procedures increased the risk of mesh exposure (P = 0.03 and P = 0.02).
Conclusion:
In abdominal sacrocolpopexy operations in which polypropylene meshes are used, stage 3 or 4 prolapse, concomitant hysterectomy and three or more additional procedures increase the risk of mesh exposure development.
Insights
Risk factors for mesh exposure after abdominal sacral colpopexy (ASC) include advanced prolapse (stage 3-4), concomitant hysterectomy, and multiple additional procedures. Previous hysterectomy was associated with lower exposure rates.
Area of Science:
- Urogynecology
- Pelvic reconstructive surgery
- Biomaterials in surgery
Background:
- Abdominal sacral colpopexy (ASC) is a surgical procedure for pelvic organ prolapse.
- Polypropylene mesh is commonly used in ASC procedures.
- Mesh exposure is a known complication of ASC, impacting patient outcomes.
Purpose of the Study:
- To identify risk factors associated with mesh exposure after abdominal sacral colpopexy.
- To compare patient demographics and risk factors between those who developed mesh exposure and those who did not.
Main Methods:
- Retrospective cohort study design.
- Analysis of patients who underwent ASC between 2002 and 2012.
- Comparison of risk factors and demographics in patients with and without mesh exposure.
Main Results:
- Mesh exposure occurred in 19 of 292 patients over 42 months.
- Higher rates of stage 3-4 prolapse were observed in the mesh exposure group (P=0.04).
- Concomitant hysterectomy (P=0.03) and ≥3 additional procedures (P=0.02) increased mesh exposure risk.
- Previous hysterectomy was linked to lower mesh exposure rates (P=0.03).
Conclusions:
- Stage 3-4 prolapse, concomitant hysterectomy, and multiple additional procedures are significant risk factors for mesh exposure following ASC.
- Understanding these risk factors can help in patient selection and surgical planning to minimize complications.
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