Related Experiment Video
Updated: Dec 28, 2025
Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
Published on: September 13, 2022
Mesh-related complications in single-incision transvaginal mesh (TVM) and laparoscopic abdominal sacrocolpopexy
Yi-Ling Li1, Yu-Wei Chang1, Tsai-Hwa Yang1
1Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan, ROC.
Objective:
Few studies have investigated the long-term impact of synthetic mesh reconstructive surgery for pelvic organ prolapse (POP) on patient outcomes. This study aimed to examine the incidence and risk factors of mesh exposure and the subsequent requirement for surgical interventions due to mesh-related complications.
Materials And Methods:
This retrospective study was conducted from November 2010 to April 2018. We recruited women with Pelvic Organ Prolapse Quantification (POP-Q) stage 3 or 4 who underwent mesh reconstructive surgery for POP, and enrolled 487 women who received transvaginal mesh (TVM) and 110 women who received laparoscopic abdominal sacrocolpopexy (LASC). Assessments included mesh exposure rate and mesh-related complications requiring surgical interventions in both groups.
Results:
In the LASC group, the overall mesh-related complication rate was 8.18% over a mean follow-up period of 18 months. Concomitant laparoscopic-assisted vaginal hysterectomy was associated with mesh exposure (OR = 9.240; 95% CI = 1.752-48.728). No patients in the concurrent supracervical hysterectomy group were exposed to mesh. In the single-incision TVM group, the overall rate of mesh-related complications was 3.29% over a mean follow-up period of 19 months. Concomitant total vaginal hysterectomy was also a risk factor for mesh exposure (OR = 4.799; 95% CI = 1.313-17.359).
Conclusion:
Preserving the cervix or uterus decreased the rate of mesh exposure in those undergoing TVM and LASC surgery. The overall rate of mesh-related complications was low after up to 8 years of follow-up.
Insights
Synthetic mesh surgery for pelvic organ prolapse (POP) has low complication rates. Preserving the cervix or uterus during transvaginal mesh (TVM) or laparoscopic abdominal sacrocolpopexy (LASC) surgery reduces mesh exposure risks.
Area of Science:
- Urogynecology
- Pelvic reconstructive surgery
- Surgical outcomes
Background:
- Pelvic organ prolapse (POP) affects many women, often requiring surgical intervention.
- Synthetic mesh has been used for POP repair, but long-term outcomes require further investigation.
- Mesh-related complications, such as exposure, can necessitate further surgical treatment.
Purpose of the Study:
- To evaluate the incidence and risk factors of mesh exposure after POP surgery.
- To assess the rate of surgical interventions required for mesh-related complications.
- To compare outcomes between transvaginal mesh (TVM) and laparoscopic abdominal sacrocolpopexy (LASC) procedures.
Main Methods:
- Retrospective study from November 2010 to April 2018.
- Inclusion of women with POP-Q stage 3 or 4 undergoing mesh surgery.
- Comparison of 487 women receiving TVM and 110 women receiving LASC, assessing mesh exposure and complications.
Main Results:
- LASC group: 8.18% mesh-related complications (mean follow-up 18 months). Laparoscopic-assisted vaginal hysterectomy increased mesh exposure risk (OR=9.240).
- TVM group: 3.29% mesh-related complications (mean follow-up 19 months). Concomitant total vaginal hysterectomy increased mesh exposure risk (OR=4.799).
- No mesh exposure occurred in patients with concurrent supracervical hysterectomy in the LASC group.
Conclusions:
- Cervix or uterus preservation is associated with decreased mesh exposure rates in both TVM and LASC surgeries.
- Overall mesh-related complication rates were low, even after up to 8 years of follow-up.
- Surgical approach and concomitant procedures influence the risk of mesh exposure in POP repair.
