Long-term mesh erosion rate following abdominal robotic reconstructive pelvic floor surgery: a prospective study and overview of the literature

Autor: Tim J. C. Paulides, Ivo A. M. J. Broeders, Paul M. Verheijen, Steven E. Schraffordt Koops, Esther C. J. Consten, Egbert Lenters, Jan J. van Iersel, Femke van Zanten
Přispěvatelé: Robotics and Mechatronics, Digital Society Institute, ​Robotics and image-guided minimally-invasive surgery (ROBOTICS)
Rok vydání: 2018
Předmět:
030232 urology & nephrology
0302 clinical medicine
Robotic Surgical Procedures
QUALITY-OF-LIFE
Prospective Studies
Prospective cohort study
Sacrocolporectopexy
030219 obstetrics & reproductive medicine
Pelvic floor
medicine.diagnostic_test
Obstetrics and Gynecology
Robotics
RANDOMIZED CONTROLLED-TRIAL
Observational Studies as Topic
medicine.anatomical_structure
Treatment Outcome
ANATOMIC OUTCOMES
Erosion
Female
Original Article
Cohort study
Mesh exposure
ORGAN PROLAPSE
medicine.medical_specialty
Reconstructive surgery
Urology
Physical examination
Pelvic Organ Prolapse
03 medical and health sciences
LAPAROSCOPIC SACRAL COLPOPEXY
MANAGEMENT
medicine
Humans
Retrospective Studies
Sacrocolpopexy
VAGINAL VAULT PROLAPSE
SUPRACERVICAL HYSTERECTOMY
business.industry
Retrospective cohort study
Rectal examination
Pelvic Floor
Plastic Surgery Procedures
Surgical Mesh
ASSISTED SACROCOLPOPEXY
FASCIA LATA
Surgery
Proctoscopy
Robotic
Laparoscopy
business
Zdroj: International Urogynecology Journal
International Urogynecology Journal, 31(7), 1423-1433. Springer
International urogynecology journal, 31(7), 1423-1433. SPRINGER LONDON LTD
ISSN: 1433-3023
0937-3462
Popis: Introduction and hypothesis The use of synthetic mesh in transvaginal pelvic floor surgery has been subject to debate internationally. Although mesh erosion appears to be less associated with an abdominal approach, the long-term outcome has not been studied intensively. This study was set up to determine the long-term mesh erosion rate following abdominal pelvic reconstructive surgery. Methods A prospective, observational cohort study was conducted in a tertiary care setting. All consecutive female patients who underwent robot-assisted laparoscopic sacrocolpopexy and sacrocolporectopexy in 2011 and 2012 were included. Primary outcome was mesh erosion. Preoperative and postoperative evaluation (6 weeks, 1 year, 5 years) with a clinical examination and questionnaire regarding pelvic floor symptoms was performed. Mesh-related complications were assessed using a transparent vaginal speculum, proctoscopy, and digital vaginal and rectal examination. Kaplan–Meier estimates were calculated for mesh erosion. A review of the literature on mesh exposure after minimally invasive sacrocolpopexy was performed (≥12 months’ follow-up). Results Ninety-six of the 130 patients included (73.8%) were clinically examined. Median follow-up time was 48.1 months (range 36.0–62.1). Three mesh erosions were diagnosed (3.1%; Kaplan–Meier 4.9%, 95% confidence interval 0–11.0): one bladder erosion for which mesh resection and an omental patch interposition were performed, and two asymptomatic vaginal erosions (at 42.7 and 42.3 months) treated with estrogen cream in one. Additionally, 22 patients responded solely by questionnaire and/or telephone; none reported mesh-related complaints. The literature, mostly based on retrospective studies, described a median mesh erosion rate of 1.9% (range 0–13.3%). Conclusions The long-term rate of mesh erosion following an abdominally placed synthetic graft is low. Electronic supplementary material The online version of this article (10.1007/s00192-019-03990-1) contains supplementary material, which is available to authorized users
Databáze: OpenAIRE
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