Mesh erosion in robotic sacrocolpopexy

Blake C. Osmundsen, Amanda Clark, Crystal Goldsmith, Kerrie Adams, Mary Denman, S(Renee) Edwards, William (Tom) Gregory

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective: This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH). Methods: This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery. The primary outcome was mesh erosion identified during 3 months of follow-up. Results: A total of 102 women underwent sacrocolpopexy, of whom 45 were with concomitant SH and 57 were with total hysterectomy (TH). Their mean age was 58 years, mean body mass index was 26.8 kg/m2, 98% were white, 6% smoked, and 25% were on systemic hormone replacement therapy. Mean preoperative Ba = +1.4, C =-2.2. These were not different between the 2 groups or by site.Within 3 months of surgery, mesh erosion was diagnosed in 8 women, all of whom had TH. No mesh erosions occurred in the SH group (14% vs 0%). Total hysterectomy mesh erosion rate at site 1 was 3% compared with 37% at site 2. Mesh type was the only identifiable difference between sites: self-cut polypropylene at site 1, precut polypropylene at site 2. Two women in the SH had abnormal uterine pathology: 1 endometrial adenocarcinoma and 1 focus of hyperplasia with atypia. Conclusions: No mesh erosions were associated with SH within the first 3 months. In TH, the graft material used may be a modifiable factor needing further investigation. Unexpected abnormal uterine pathologic diagnosis remains a possibility with SH. Longer-term follow-up and a randomized trial are warranted to answer these questions.

Original languageEnglish (US)
Pages (from-to)86-88
Number of pages3
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume18
Issue number2
DOIs
StatePublished - 2012

Fingerprint

Robotics
Hysterectomy
Polypropylenes
Hormone Replacement Therapy
Hyperplasia
Adenocarcinoma
Body Mass Index
Cohort Studies
Retrospective Studies
Pathology
Transplants

Keywords

  • Erosion
  • Hysterectomy
  • Mesh
  • Robotic
  • Sacrocolpopexy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Surgery
  • Urology

Cite this

Mesh erosion in robotic sacrocolpopexy. / Osmundsen, Blake C.; Clark, Amanda; Goldsmith, Crystal; Adams, Kerrie; Denman, Mary; Edwards, S(Renee); Gregory, William (Tom).

In: Female Pelvic Medicine and Reconstructive Surgery, Vol. 18, No. 2, 2012, p. 86-88.

Research output: Contribution to journalArticle

Osmundsen, Blake C. ; Clark, Amanda ; Goldsmith, Crystal ; Adams, Kerrie ; Denman, Mary ; Edwards, S(Renee) ; Gregory, William (Tom). / Mesh erosion in robotic sacrocolpopexy. In: Female Pelvic Medicine and Reconstructive Surgery. 2012 ; Vol. 18, No. 2. pp. 86-88.
@article{a78f19027efb4b239d0f994a0d90da45,
title = "Mesh erosion in robotic sacrocolpopexy",
abstract = "Objective: This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH). Methods: This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery. The primary outcome was mesh erosion identified during 3 months of follow-up. Results: A total of 102 women underwent sacrocolpopexy, of whom 45 were with concomitant SH and 57 were with total hysterectomy (TH). Their mean age was 58 years, mean body mass index was 26.8 kg/m2, 98{\%} were white, 6{\%} smoked, and 25{\%} were on systemic hormone replacement therapy. Mean preoperative Ba = +1.4, C =-2.2. These were not different between the 2 groups or by site.Within 3 months of surgery, mesh erosion was diagnosed in 8 women, all of whom had TH. No mesh erosions occurred in the SH group (14{\%} vs 0{\%}). Total hysterectomy mesh erosion rate at site 1 was 3{\%} compared with 37{\%} at site 2. Mesh type was the only identifiable difference between sites: self-cut polypropylene at site 1, precut polypropylene at site 2. Two women in the SH had abnormal uterine pathology: 1 endometrial adenocarcinoma and 1 focus of hyperplasia with atypia. Conclusions: No mesh erosions were associated with SH within the first 3 months. In TH, the graft material used may be a modifiable factor needing further investigation. Unexpected abnormal uterine pathologic diagnosis remains a possibility with SH. Longer-term follow-up and a randomized trial are warranted to answer these questions.",
keywords = "Erosion, Hysterectomy, Mesh, Robotic, Sacrocolpopexy",
author = "Osmundsen, {Blake C.} and Amanda Clark and Crystal Goldsmith and Kerrie Adams and Mary Denman and S(Renee) Edwards and Gregory, {William (Tom)}",
year = "2012",
doi = "10.1097/SPV.0b013e318246806d",
language = "English (US)",
volume = "18",
pages = "86--88",
journal = "Female Pelvic Medicine and Reconstructive Surgery",
issn = "2151-8378",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Mesh erosion in robotic sacrocolpopexy

AU - Osmundsen, Blake C.

AU - Clark, Amanda

AU - Goldsmith, Crystal

AU - Adams, Kerrie

AU - Denman, Mary

AU - Edwards, S(Renee)

AU - Gregory, William (Tom)

PY - 2012

Y1 - 2012

N2 - Objective: This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH). Methods: This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery. The primary outcome was mesh erosion identified during 3 months of follow-up. Results: A total of 102 women underwent sacrocolpopexy, of whom 45 were with concomitant SH and 57 were with total hysterectomy (TH). Their mean age was 58 years, mean body mass index was 26.8 kg/m2, 98% were white, 6% smoked, and 25% were on systemic hormone replacement therapy. Mean preoperative Ba = +1.4, C =-2.2. These were not different between the 2 groups or by site.Within 3 months of surgery, mesh erosion was diagnosed in 8 women, all of whom had TH. No mesh erosions occurred in the SH group (14% vs 0%). Total hysterectomy mesh erosion rate at site 1 was 3% compared with 37% at site 2. Mesh type was the only identifiable difference between sites: self-cut polypropylene at site 1, precut polypropylene at site 2. Two women in the SH had abnormal uterine pathology: 1 endometrial adenocarcinoma and 1 focus of hyperplasia with atypia. Conclusions: No mesh erosions were associated with SH within the first 3 months. In TH, the graft material used may be a modifiable factor needing further investigation. Unexpected abnormal uterine pathologic diagnosis remains a possibility with SH. Longer-term follow-up and a randomized trial are warranted to answer these questions.

AB - Objective: This study aimed to compare the incidence of mesh erosion after robotic sacrocolpopexy between women undergoing total and those undergoing supracervical hysterectomy (SH). Methods: This is a retrospective cohort study of women who underwent sacrocolpopexy and concomitant hysterectomy using the DaVinci surgical robot between May 2007 and December 2010 at 2 sites. Baseline data were gathered before surgery. The primary outcome was mesh erosion identified during 3 months of follow-up. Results: A total of 102 women underwent sacrocolpopexy, of whom 45 were with concomitant SH and 57 were with total hysterectomy (TH). Their mean age was 58 years, mean body mass index was 26.8 kg/m2, 98% were white, 6% smoked, and 25% were on systemic hormone replacement therapy. Mean preoperative Ba = +1.4, C =-2.2. These were not different between the 2 groups or by site.Within 3 months of surgery, mesh erosion was diagnosed in 8 women, all of whom had TH. No mesh erosions occurred in the SH group (14% vs 0%). Total hysterectomy mesh erosion rate at site 1 was 3% compared with 37% at site 2. Mesh type was the only identifiable difference between sites: self-cut polypropylene at site 1, precut polypropylene at site 2. Two women in the SH had abnormal uterine pathology: 1 endometrial adenocarcinoma and 1 focus of hyperplasia with atypia. Conclusions: No mesh erosions were associated with SH within the first 3 months. In TH, the graft material used may be a modifiable factor needing further investigation. Unexpected abnormal uterine pathologic diagnosis remains a possibility with SH. Longer-term follow-up and a randomized trial are warranted to answer these questions.

KW - Erosion

KW - Hysterectomy

KW - Mesh

KW - Robotic

KW - Sacrocolpopexy

UR - http://www.scopus.com/inward/record.url?scp=84860620497&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84860620497&partnerID=8YFLogxK

U2 - 10.1097/SPV.0b013e318246806d

DO - 10.1097/SPV.0b013e318246806d

M3 - Article

C2 - 22453317

AN - SCOPUS:84860620497

VL - 18

SP - 86

EP - 88

JO - Female Pelvic Medicine and Reconstructive Surgery

JF - Female Pelvic Medicine and Reconstructive Surgery

SN - 2151-8378

IS - 2

ER -