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Akyol A, Akca A, Ulker V, Gedikbasi A, Kublay A, Han A, Ark HC, Numanoglu C. Additional surgical risk factors and patient characteristics for mesh erosion after abdominal sacrocolpopexy. J Obstet Gynaecol Res 2014; 40:1368-74. [DOI: 10.1111/jog.12363] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 11/25/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Alpaslan Akyol
- Department of Obstetrics and Gynecology; Firat University Faculty of Medicine; Elazig Turkey
| | - Aysu Akca
- Department of Obstetrics and Gynecology; Kanuni Sultan Süleyman Training and Research Hospital; Istanbul Turkey
| | - Volkan Ulker
- Department of Obstetrics and Gynecology; Kanuni Sultan Süleyman Training and Research Hospital; Istanbul Turkey
| | - Ali Gedikbasi
- Department of Obstetrics and Gynecology; Kanuni Sultan Süleyman Training and Research Hospital; Istanbul Turkey
| | - Arzu Kublay
- Department of Obstetrics and Gynecology; Kanuni Sultan Süleyman Training and Research Hospital; Istanbul Turkey
| | - Agahan Han
- Department of Obstetrics and Gynecology; Kanuni Sultan Süleyman Training and Research Hospital; Istanbul Turkey
| | - Hasan Cemal Ark
- Department of Obstetrics and Gynecology; Kanuni Sultan Süleyman Training and Research Hospital; Istanbul Turkey
| | - Ceyhun Numanoglu
- Department of Obstetrics and Gynecology; Kanuni Sultan Süleyman Training and Research Hospital; Istanbul Turkey
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Investigating the clinical significance of mesh peritonization in abdominal vault suspension surgery using a comparative rabbit model. Eur J Obstet Gynecol Reprod Biol 2014; 175:199-204. [DOI: 10.1016/j.ejogrb.2014.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 12/21/2013] [Accepted: 01/02/2014] [Indexed: 11/17/2022]
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Ulukent SC, Kaya B, Bat O, Sahbaz NA, Akca O, Akyol A. Prolene mesh migration into the rectum after sacral colpopexy presented with frozen pelvis. Int J Surg Case Rep 2013; 4:1004-6. [PMID: 24091077 PMCID: PMC3825976 DOI: 10.1016/j.ijscr.2013.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 07/26/2013] [Accepted: 08/08/2013] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Pelvic organ prolapse (POP) is a common gynecological problem. Repair with synthetic materials such as prolene mesh has become a popular approach in prolapsus surgery. Migration of synthetic materials can cause serious complications. PRESENTATION OF CASE A 69-year-old woman was admitted to the hospital with a complaint of sensation of fullness and a feeling of a foreign material protruding during defecation. The patient underwent exploratory laparotomy. Prolene mesh was detected in sacral region but resection of the mesh could not be conducted because of dense adhesions causing frozen pelvis. The migrated prolene mesh was resected transanally. DISCUSSION Genital prolapse or genital hernia is described as the protrusion of pelvic organs along the vagina. It is one of the common gynecological conditions that affect the quality of life in women. Mesh migration is a well-known clinical pathology. CONCLUSION Mesh migration is a serious complication after sacral colpopexy. Surgical resection of migrated mesh can be difficult due to dense adhesions.
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Affiliation(s)
- Suat Can Ulukent
- Kanuni Sultan Suleyman Training and Research Hospital, Department of General Surgery, Istanbul, Turkey
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Mourmouris PI, Skolarikos A, Mitsogiannis IC, Migdalis V, Papatsoris AG. Laparoscopic surgical repair of pelvic organ prolapse and female stress urinary incontinence. World J Obstet Gynecol 2013; 2:47-52. [DOI: 10.5317/wjog.v2.i3.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 04/06/2013] [Accepted: 06/10/2013] [Indexed: 02/05/2023] Open
Abstract
Pelvic organ prolapse (POP) occurs in a relatively big population of women which is continuously increasing and is associated with a variety of urinary bowel and sexual symptoms. As this problem magnifies, the need for surgical repair is increasing relatively. The main goals of surgical repair for POP include: no anatomic prolapse, no functional symptoms, patient satisfaction and avoidance of complications, goals that cannot always be fully achieved. The decision for the type of surgery depends of various factors such as patient characteristics and prolapsed compartment but also by the surgeon expertise. The laparoscopic approach is already the gold standard procedure for many urologic procedures and can also be used for the treatment of POP and stress urinary incontinence. Herein, we review the literature about the available data concerning laparoscopic surgery techniques for treating POP.
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Takase-Sanchez MM, Hale DS. Minimally Invasive Pelvic Reconstructive Surgery: A Literature Review of Laparoscopic Surgery for Pelvic Organ Prolapse. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2013. [DOI: 10.1007/s13669-013-0050-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McPencow AM, Erekson EA, Guess MK, Martin DK, Patel DA, Xu X. Cost-effectiveness of endometrial evaluation prior to morcellation in surgical procedures for prolapse. Am J Obstet Gynecol 2013; 209:22.e1-9. [PMID: 23545164 DOI: 10.1016/j.ajog.2013.03.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 03/13/2013] [Accepted: 03/27/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of the study was to compare the cost-effectiveness of 3 screening options for endometrial cancer in asymptomatic, postmenopausal women prior to undergoing morcellation in minimally invasive supracervical hysterectomy and minimally invasive sacral colpopexy for the treatment of pelvic organ prolapse. STUDY DESIGN A decision tree model was constructed to compare no screening, endometrial biopsy, and transvaginal ultrasound for asymptomatic, postmenopausal women prior to surgery. Effectiveness was measured by life-years. The incremental cost-effectiveness ratio, defined as the difference in cost between 2 screening options divided by the difference in life-years between the 2 options, was calculated in 2012 US dollars for endometrial biopsy and transvaginal ultrasound, in comparison with no screening. RESULTS Using an endometrial cancer prevalence of 0.6% and a 40% risk of upstaging after morcellation, the expected per-patient cost was $8800, $9023, and $9112 over 5 years for no screening, endometrial biopsy, and transvaginal ultrasound, respectively. The expected life-years saved compared with no screening were 0.00108 for endometrial biopsy and 0.00105 for transvaginal ultrasound, ie, 0.39 and 0.38 days, respectively. The estimated incremental cost-effectiveness ratio was $207,348 for endometrial biopsy and $298,038 for transvaginal ultrasound compared with no screening. A sensitivity analysis showed that the prevalence of endometrial cancer and the risk of endometrial cancer upstaging after morcellation had the greatest impact on the cost-effectiveness of screening. CONCLUSION For asymptomatic, postmenopausal women, preoperative endometrial evaluation via endometrial biopsy or transvaginal ultrasound helps improve the preoperative detection of endometrial cancer, but universal screening is not cost effective.
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Affiliation(s)
- Alexandra M McPencow
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT.
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Moser JE, Geels JJ. Migration of extraluminal tracheal ring prostheses after tracheoplasty for treatment of tracheal collapse in a dog. J Am Vet Med Assoc 2013; 243:102-4. [DOI: 10.2460/javma.243.1.102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Badrek-Al Amoudi AH, Greenslade GL, Dixon AR. How to deal with complications after laparoscopic ventral mesh rectopexy: lessons learnt from a tertiary referral centre. Colorectal Dis 2013; 15:707-12. [PMID: 23384148 DOI: 10.1111/codi.12164] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Accepted: 01/13/2013] [Indexed: 12/15/2022]
Abstract
AIM Laparoscopic ventral mesh rectopexy (LVMR) is increasingly recognized as having utility in rectal prolapse, obstructive defaecation syndrome (ODS), faecal incontinence (FI) and multicompartment pelvic floor dysfunction (PFD). This study aimed to highlight gaps in service provision and areas for improvement by examining a cohort of patients with complications referred to a tertiary centre. METHOD Examination was carried out of a password-protected electronic database of all LVMRs operated on in one institution. RESULTS Fifty patients (45 women), median age 54 (range, 24-71) years, were referred with early symptomatic failure (n = 27) following an inadequate LVMR or major mesh complications (erosion into another organ, fistulation or stricturing) (n = 23). All were amenable to remedial laparoscopic surgery. Functional improvements were found in pre- and postoperative ODS, Wexner (FI) scores (two-tailed t-test; P < 0.0001) and quality of life (Birmingham Bowel and Urinary Symptoms Questionnaire-22) scores at 3 months (two-tailed t-test; P < 0.001) and normalization at 1 year (P < 0.015). This was mirrored by improved linear bowel symptom severity visual analogue scale scores (two-tailed t-test; P < 0.0001 at 3 months and P = 0.015 at 1 year) . CONCLUSION LVMR can be associated with technical complications arising from inadequate technique or from operation-specific complications that are amenable to complex revisional laparoscopic surgery with significant improvement in quality of life and function.
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Affiliation(s)
- A H Badrek-Al Amoudi
- Colorectal & Pelvic Floor Surgery, Frenchay & SPIRE Hospitals Bristol, Bristol, UK
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61
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Khunda A, Vashisht A, Cutner A. New procedures for uterine prolapse. Best Pract Res Clin Obstet Gynaecol 2013; 27:363-79. [DOI: 10.1016/j.bpobgyn.2012.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 12/03/2012] [Indexed: 10/27/2022]
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62
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Zhu L, Sun Z, Yu M, Li B, Li X, Lang J. Modified laparoscopic sacrocolpopexy with mesh for severe pelvic organ prolapse. Int J Gynaecol Obstet 2013; 121:170-2. [DOI: 10.1016/j.ijgo.2012.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 11/24/2012] [Accepted: 01/14/2013] [Indexed: 10/27/2022]
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Yoon WS, Lee HN, Lee YS, Jeung IC, Park EK. Laparoscopic colposuspension to the Cooper's ligament after hysterectomy for uterovaginal prolapse. J Obstet Gynaecol Res 2012; 39:714-9. [PMID: 23167590 DOI: 10.1111/j.1447-0756.2012.02038.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 06/30/2012] [Indexed: 11/29/2022]
Abstract
AIM The goal of this study was to evaluate the long-term outcomes of laparoscopic colposuspension to the Cooper's ligament after hysterectomy for uterovaginal prolapse. MATERIAL AND METHODS We performed chart reviews of 43 patients with uterovaginal prolapse who underwent laparoscopic colposuspension to the Cooper's ligament after hysterectomy at Daejeon St. Mary's Hospital, Catholic University of Korea from 2003 to 2009. These patients exhibited grade 3 (29 patients) or grade 4 (14 patients) uterovaginal prolapse. RESULTS The mean age was 63.2 years (range, 39-76). The mean follow-up period was 44.2 months (95% CI, 36.8-51.5). Forty-three patients showed no sign or recurrence of prolapse. Postoperative complications were tolerable and curable. Urinary frequency (2 patients, 4.7%), voiding difficulty (2 patients, 4.7%), nocturia (1 patient, 2.3%) and vaginal spotting (1 patient, 2.3%) were reported. CONCLUSION Laparoscopic colposuspension using Cooper's ligament after hysterectomy could be an effective surgical option for the treatment of uterovaginal prolapse.
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Affiliation(s)
- Won Sik Yoon
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Korea
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64
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Deffieux X, Letouzey V, Savary D, Sentilhes L, Agostini A, Mares P, Pierre F. Prevention of complications related to the use of prosthetic meshes in prolapse surgery: guidelines for clinical practice. Eur J Obstet Gynecol Reprod Biol 2012; 165:170-80. [PMID: 22999444 DOI: 10.1016/j.ejogrb.2012.09.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 08/01/2012] [Accepted: 09/03/2012] [Indexed: 11/19/2022]
Abstract
The objective of the study was to provide guidelines for clinical practice from the French College of Obstetrics and Gynecology (CNGOF), based on the best evidence available, concerning adverse events related to surgical procedures involving the use of prosthetic meshes. French and English-language articles from Medline, PubMed, and the Cochrane Database were searched, using key words (mesh; pelvic organ prolapse; cystocele; rectocele; uterine prolapse; complications; adverse event; sacral colpopexy; extrusion; infection). As with any surgery, recommendations include perioperative smoking cessation (Expert opinion) and compliance with the prevention of nosocomial infections (regulatory recommendation). There is no evidence to recommend routine local or systemic estrogen therapy before or after prolapse surgery using mesh, regardless of the surgical approach (Grade C). Antibiotic prophylaxis is recommended, regardless of the approach (Expert opinion). It is recommended to check for pre-operative urinary tract infection and treat it (Expert opinion). The first procedure should be undertaken under the guidance of a surgeon experienced in the relevant technique (Grade C). It is recommended not to place a non-absorbable synthetic mesh into the rectovaginal septum when a rectal injury occurs (Expert opinion). Placement of a non-absorbable synthetic mesh into the vesicovaginal septum may be considered after suturing of a bladder injury if the suture is considered to be satisfactory (Expert opinion). If a synthetic mesh is placed by vaginal route, it is recommended to use a macroporous polypropylene monofilament mesh (Grade B). It is recommended not to use polyester mesh for vaginal surgery (Grade B). It is permissible to perform hysterectomy associated with the placement of a non-absorbable synthetic mesh placed by the vaginal route but this is not routinely recommended (Expert opinion). It is recommended to minimize the extent of the colpectomy (Expert opinion). The laparoscopic approach is recommended for sacral colpopexy (Expert opinion). It is recommended not to place and suture meshes by the vaginal route when a sacral colpopexy is performed (Grade B). It is recommended not to use silicone-coated polyester, porcine dermis, fascia lata, and polytetrafluoroethylene meshes (Grade B). It is recommended to use polyester (without silicone coating) or polypropylene meshes (Grade C). Suture of the meshes to the promontory can be performed using thread/needle or tacks (Grade C). Peritonization is recommended to cover the meshes (Grade C). If hysterectomy is required, it is recommended to perform a subtotal hysterectomy (Expert opinion). Implementation of this guideline should decrease the prevalence of complications related to surgical procedures involving the use of prosthetic meshes.
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Affiliation(s)
- Xavier Deffieux
- AP-HP, Hôpital Antoine Béclère, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Clamart, F-92141, France.
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65
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Mesh erosion following abdominal sacral colpopexy in the absence and presence of the cervical stump. Int Urogynecol J 2012; 24:113-8. [PMID: 22717784 DOI: 10.1007/s00192-012-1845-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 05/20/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We compared the role of abdominal sacral colpopexy (ASCP) with concomitant supracervical hysterectomy to ASCP alone in patients with prior hysterectomy in the prevention of mesh erosion. MATERIALS AND METHODS We performed a retrospective chart review of 277 consecutive patients who underwent ASCP with one surgeon. Patients were separated into two groups based on the presence of a uterus at the time of surgery. Group A comprised195 patients with a uterus who underwent ASCP and concomitant supracervical hysterectomy; group B comprised 82 patients with prior total hysterectomy who underwent ASCP. The outcome measures included peri- and postoperative findings, complications, and surgical success. Data were analyzed by t test and chi-square test using SPSS software. RESULTS No significant difference was found between groups during surgery in terms of anesthesia type, total operative time, and estimated intraoperative blood loss. At mean postoperative follow-up of 7-8 months, there was no difference between groups in terms of de novo urinary symptoms, recurrent vaginal-wall prolapse, or dyspareunia and Pelvic Organ Prolapse Quantification (POP-Q) point C examination. Sling erosion was observed in four (4.2 %) patients in group A versus none in group B. Apical mesh erosion was diagnosed in one patient in group A (0.5 %) and two (2.4 %) patients in group B. These differences were not statistically significant. CONCLUSION Concomitant supracervical hysterectomy with ASCP was associated with a low incidence of mesh erosion and had the same intraoperative course and postoperative outcome as ASCP with previous hysterectomy.
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66
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Soules K, Winters JC, Chermansky CJ. Central compartment and apical defect repair using synthetic mesh. Curr Urol Rep 2012; 13:222-30. [PMID: 22572982 DOI: 10.1007/s11934-012-0253-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Pelvic organ prolapse is an increasingly common condition for women that has been challenging to treat due to high recurrence rates after surgical repair. The introduction of mesh-augmented prolapse repairs as a means to achieve more robust repairs had great initial promise. As more data emerge on outcomes and novel mesh complications, the when and where of mesh augmentation has become much less clear. This article reviews the relevant literature on the use of mesh in central and apical repairs. This includes a detailed look at the available data for vaginal mesh kits and several recent trials comparing mesh kits to traditional repairs. The article ends with a discussion of the recent U.S. Food and Drug Administration (FDA) safety communication on the use of transvaginal mesh in pelvic organ prolapse and the authors' views of how practice may change in this new environment.
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Affiliation(s)
- Karen Soules
- Department of Urology, Louisiana State University Health Sciences Center New Orleans, 70112, USA
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67
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Comparison of vaginal mesh extrusion rates between a lightweight type I polypropylene mesh versus heavier mesh in the treatment of pelvic organ prolapse. Int Urogynecol J 2012; 23:1379-86. [DOI: 10.1007/s00192-012-1744-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 03/04/2012] [Indexed: 01/05/2023]
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68
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Hamada H. [Laparoscopic surgery in the treatment of urogenital prolapse. Current status]. JOURNAL DE GYNECOLOGIE, OBSTETRIQUE ET BIOLOGIE DE LA REPRODUCTION 2012; 41:399-408. [PMID: 22552102 DOI: 10.1016/j.jgyn.2012.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 02/16/2012] [Accepted: 03/19/2012] [Indexed: 11/26/2022]
Abstract
Urogenital prolapse is an emerging problem because of the increasing life expectancy of populations. Nearly 42% of women between 15 and 97 years have a pelvic floor disorder (PFD). On the basis of Medline search, we present the main laparoscopical techniques to treat PFD: Burch, sacrocolpopexy, lateral suspension, uterosacral suspension, paravaginal repair, the benefits of laparoscopic surgery, its success rates and complications, and response to various questions that frequently arise about some techniques: should we perform a hysterectomy? Should we make a paravaginal repair? Should we treat prophylactically a stress urinary incontinence? What type of mesh should we use? What to prefer: staples or sutures? Is the posterior mesh necessary?
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Affiliation(s)
- H Hamada
- Maternité de l'hôpital El Idrissi, Kénitra, Morocco. Halima
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69
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Seman EI, Bedford ND, O’Shea RT, Keirse MJ. Laparoscopic Supralevator Repair for Combined Apical and Posterior Compartment Prolapse. J Minim Invasive Gynecol 2012; 19:339-43. [DOI: 10.1016/j.jmig.2012.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 12/24/2011] [Accepted: 01/05/2012] [Indexed: 10/28/2022]
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70
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Shah HN, Badlani GH. Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review. Indian J Urol 2012; 28:129-53. [PMID: 22919127 PMCID: PMC3424888 DOI: 10.4103/0970-1591.98453] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We reviewed the incidence, predisposing factors, presentation and management of complications related to the use of synthetic mesh in the management of stress urinary incontinence and pelvic organ prolapse repair. Immediate complications, such as bleeding, hematoma, injury to adjacent organs during placement of mesh and complication of voiding dysfunction are not discussed in this review, since they are primarily related to technique. A PubMed search of related articles published in English was done from April 2008 to March 2011. Key words used were urinary incontinence, mesh, complications, midurethral sling, anterior prolapse, anterior vaginal repair, pelvic organ prolapse, transvaginal mesh, vault prolapse, midurethral slings, female stress urinary incontinence, mesh erosion, vaginal mesh complications, and posterior vaginal wall prolapse. Since there were very few articles dealing with the management of mesh-related complications in the period covered in the search we extended the search from January 2005 onwards. Articles were selected to fit the scope of the topic. In addition, landmark publications and Manufacturer and User Facility Device Experience (MAUDE) data (FDA website) were included on the present topic. A total of 170 articles were identified. The use of synthetic mesh in sub-urethral sling procedures is now considered the standard for the surgical management of stress urinary incontinence. Synthetic mesh is being increasingly used in the management of pelvic organ prolapse. While the incidence of extrusion and erosion with mid-urethral sling is low, the extrusion rate in prolapse repair is somewhat higher and the use in posterior compartment remains controversial. When used through the abdominal approach the extrusion and erosion rates are lower. The management of mesh complication is an individualized approach. The choice of the technique should be based on the type of mesh complication, location of the extrusion and/or erosion, its magnitude, severity and potential recurrence of pelvic floor defect.
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Affiliation(s)
- Hemendra N. Shah
- Wake Forest University School of Medicine, Department of Urology, Medical Center Boulevard, Winston-Salem, NC, country USA
| | - Gopal H. Badlani
- Wake Forest University School of Medicine, Department of Urology, Medical Center Boulevard, Winston-Salem, NC, country USA
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71
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Effect of Operative Technique on Mesh Exposure in Laparoscopic Sacrocolpopexy. Female Pelvic Med Reconstr Surg 2012; 18:113-7. [DOI: 10.1097/spv.0b013e318249bd54] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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72
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Roth TM, Reight I. Laparoscopic mesh explantation and drainage of sacral abscess remote from transvaginal excision of exposed sacral colpopexy mesh. Int Urogynecol J 2012; 23:953-5. [PMID: 22237786 DOI: 10.1007/s00192-011-1630-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 12/06/2011] [Indexed: 11/27/2022]
Abstract
Sacral colpopexy may be complicated by mesh exposure, and the surgical treatment of mesh exposure typically results in minor postoperative morbidity and few delayed complications. A 75-year-old woman presented 7 years after a laparoscopic sacral colpopexy, with Mersilene mesh, with an apical mesh exposure. She underwent an uncomplicated transvaginal excision and was asymptomatic until 8 months later when she presented with vaginal drainage and a sacral abscess. This was successfully treated with laparoscopic enterolysis, drainage of the abscess, and explantation of the remaining mesh. Incomplete excision of exposed colpopexy mesh can lead to ascending infection and sacral abscess. Laparoscopic drainage and mesh removal may be considered in these patients.
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Affiliation(s)
- Ted M Roth
- Women's Specialty Center/Bladder Control Center, Central Maine Medical Center, Lewiston, ME 04240, USA.
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73
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Deffieux X, Savary D, Letouzey V, Sentilhes L, Agostini A, Mares P, Pierre F. Prévenir les complications de la chirurgie prothétique du prolapsus : recommandations pour la pratique clinique – Revue de la littérature. ACTA ACUST UNITED AC 2011; 40:827-50. [PMID: 22056180 DOI: 10.1016/j.jgyn.2011.09.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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74
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Place de l’hystérectomie supracervicale et de l’abord cœlioscopique pour fibromes symptomatiques. ACTA ACUST UNITED AC 2011; 40:944-52. [DOI: 10.1016/j.jgyn.2011.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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75
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"Like a rabbit from a hat!"--a case of a sacrocolpopexy mesh being taken out by a patient. Int Urogynecol J 2011; 23:503-4. [PMID: 21887543 DOI: 10.1007/s00192-011-1550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 08/10/2011] [Indexed: 10/17/2022]
Abstract
Sacrocolpopexy, be it laparoscopic or abdominal, is associated with a risk of mesh extrusion. We report an interesting case of mesh extrusion with subsequent removal of the mesh from the vagina by the patient. We take this opportunity to review the literature regarding incidence, predisposing factors and complications of sacrocolpopexy mesh extrusion with specific reference to this case.
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76
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Trompoukis P, Nassif J, Gabriel B, Wattiez A. Internal hernia after laparoscopic sacrocervicopexy. J Minim Invasive Gynecol 2011; 18:525-7. [PMID: 21777844 DOI: 10.1016/j.jmig.2011.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 03/02/2011] [Accepted: 03/10/2011] [Indexed: 11/16/2022]
Abstract
Whether the peritoneum covering the mesh used in laparoscopic procedures to treat pelvic organ prolapse needs to be sutured is controversial. Herein is reported a case of small bowel obstruction through the mesh, which was sutured at the level of the sacral promontory. The objective of this case report was to emphasize the importance of peritonization, or "burial," of the mesh during these laparoscopic procedures to avert bowel herniation. Furthermore, the need is stressed for a low operative threshold in patients who have undergone such laparoscopic procedures and who demonstrate symptoms of acute abdomen.
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Affiliation(s)
- Pantelis Trompoukis
- IRCAD/EITS Strasbourg, Department of Gynecology, Hôpitaux Universitaires, Strasbourg, France.
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77
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A Pilot Study on Vaginally Assisted Laparoscopic Sacrocolpopexy for Patients With Uterovaginal Prolapse. Female Pelvic Med Reconstr Surg 2011; 17:115-9. [DOI: 10.1097/spv.0b013e318216379d] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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78
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Laparoscopic sacral colpoperineopexy: abdominal versus abdominal–vaginal posterior graft attachment. Int Urogynecol J 2010; 22:469-75. [DOI: 10.1007/s00192-010-1302-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Accepted: 10/03/2010] [Indexed: 10/18/2022]
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79
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Tan-Kim J, Menefee SA, Luber KM, Nager CW, Lukacz ES. Prevalence and risk factors for mesh erosion after laparoscopic-assisted sacrocolpopexy. Int Urogynecol J 2010; 22:205-12. [PMID: 20842494 PMCID: PMC3025104 DOI: 10.1007/s00192-010-1265-3] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Accepted: 08/29/2010] [Indexed: 12/18/2022]
Abstract
Introduction and hypothesis The purpose of this study is to identify risk factors for mesh erosion in women undergoing minimally invasive sacrocolpopexy (MISC). We hypothesize that erosion is higher in subjects undergoing concomitant hysterectomy. Methods This is a retrospective cohort study of women who underwent MISC between November 2004 and January 2009. Demographics, operative techniques, and outcomes were abstracted from medical records. Multivariable regression identified odds of erosion. Results Of 188 MISC procedures 19(10%) had erosions. Erosion was higher in those with total vaginal hysterectomy (TVH) compared to both post-hysterectomy (23% vs. 5%, p = 0.003) and supracervical hysterectomy (SCH) (23% vs. 5%, p = 0.109) groups. In multivariable regression, the odds of erosion for TVH was 5.67 (95% CI: 1.88–17.10) compared to post-hysterectomy. Smoking, the use of collagen-coated mesh, transvaginal dissection, and mesh attachment transvaginally were no longer significant in the multivariable regression model. Conclusion Based on this study, surgeons should consider supracervical hysterectomy over total vaginal hysterectomy as the procedure of choice in association with MISC unless removal of the cervix is otherwise indicated.
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Affiliation(s)
- Jasmine Tan-Kim
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Reproductive Medicine, University of California, San Diego, La Jolla, CA, USA.
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80
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Use of Surgisis mesh in the management of polypropylene mesh erosion into the vagina. Int Urogynecol J 2010; 22:41-6. [PMID: 20700727 DOI: 10.1007/s00192-010-1234-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Accepted: 07/23/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS mesh in pelvic reconstructive surgery is being used increasingly in clinical practice. Complications such as mesh erosion and dyspareunia can cause significant patient morbidity. In cases where vaginal mesh erosions are large or multifocal resulting in inadequate healthy epithelium for repair, this may lead to recurrent mesh erosion or vaginal stenosis. METHOD nine patients with synthetic mesh erosion who failed to respond to conservative measures were managed surgically with Surgisis. RESULTS the median time at which patients presented with mesh erosion was 12 weeks. The size of erosion ranged from 1 to 4 cm in diameter. At follow-up, five patients were cured, three still had evidence of mesh erosion although the overall defects were smaller, and one patient required further surgery. CONCLUSION with mesh erosion being a troublesome reality following insertion of synthetic mesh repairs, Surgisis may prove to be a useful option in the treatment of large vaginal mesh defects.
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81
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Paine M, Harnsberger JR, Whiteside JL. Transrectal mesh erosion remote from sacrocolpopexy: management and comment. Am J Obstet Gynecol 2010; 203:e11-3. [PMID: 20510183 DOI: 10.1016/j.ajog.2010.04.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 04/07/2010] [Accepted: 04/15/2010] [Indexed: 11/25/2022]
Abstract
Sacrocolpopexy is an effective treatment for advanced pelvic organ prolapse with predictable anatomic and functional outcomes. We describe a rare complication of mesh erosion into the rectum and subsequent multidisciplinary management. Multidisciplinary, experienced subspecialty care can address difficult complications of pelvic floor surgery with a minimally invasive approach.
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82
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Abdominal, laparoscopic, and robotic surgery for pelvic organ prolapse. Obstet Gynecol Clin North Am 2010; 36:585-614. [PMID: 19932417 DOI: 10.1016/j.ogc.2009.09.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abdominal correction of pelvic organ prolapse remains a viable option for patients and surgeons. The transition from open procedures to less invasive laparoscopic and robotic-assisted surgeries is evident in the literature. This article reviews the surgical options available for pelvic organ prolapse repair and their reported outcomes. Procedures reviewed include apical support (sacral, uterosacral, and others), and abdominal anterior and posterior vaginal wall support. Long-term follow-up and appropriately designed studies will further help direct surgeons in deciding which approach to incorporate into their practice.
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83
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Sabbagh R, Mandron E, Piussan J, Brychaert PE, Tu LM. Long-term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse. BJU Int 2010; 106:861-6. [PMID: 20089111 DOI: 10.1111/j.1464-410x.2009.09173.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To assess the long-term anatomical and functional outcomes of laparoscopic promontofixation (LP) for pelvic organ prolapse (POP), and the long-term safety of LP, as POP is a common problem in women of all ages, with treatment including vaginal, abdominal, laparoscopic or robot-assisted surgical approaches. PATIENTS AND METHODS This was a retrospective study of the first consecutive 186 women who underwent LP for POP, with or without stress urinary incontinence (SUI), from January 1998 to December 2002 in one centre. Those patients with concurrent SUI had LP with a Burch colposuspension or tension-free vaginal tape (TVT). The recurrence rate of POP was evaluated by physical examination at follow-up visits and by the patients, using a postal, unvalidated self-applied questionnaire (SAQ). Patients' urinary, sexual and digestive functions, overall satisfaction about surgery and quality of life, were evaluated with SAQ. RESULTS All 186 patients had LP, with concomitant Burch (25) or TVT (100) procedures. The median (interquartile range) follow-up was 60 (48-71) months. In all, 71% of the patients attended their follow-up visits and the success rate was 92.4%. Eight patients were re-operated because of recurrent POP. The SAQ response rate was 95%; 91.1% and 79.8% of responders were satisfied or very satisfied after their surgery, and with their quality of life, respectively; women were unsatisfied or very unsatisfied because of recurrence of POP (seven), urinary symptoms (five) or constipation (two). Patients complained of recurrent POP (10.8%), persistent or recurrent UI (27.3% of the women treated with Burch and 21.1% with TVT), and transient constipation (20%). Over half of the women (50.6%) were not sexually active and 5.4% developed dyspareunia. The long-term complication rate was 6%; there were five vaginal mesh erosions. CONCLUSION POP treated with LP offers excellent long-term results with low recurrence and morbidity rates, and a good quality of life.
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Affiliation(s)
- Robert Sabbagh
- Centre Hospitalier Universitaire de Sherbrooke, Quebec, Canada.
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84
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Fatton B, Wagner L, Delmas V, Haab F, Costa P. Place de l’hystérectomie lors de la cure de prolapsus par promontofixation. Prog Urol 2009; 19:1006-13. [DOI: 10.1016/j.purol.2009.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 09/21/2009] [Indexed: 11/25/2022]
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85
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Abstract
Laparoscopy provides an enticing alternative for incontinence and pelvic floor procedures that would otherwise require a laparotomy or that would be difficult vaginally. Despite some data suggesting lower cure rates with the laparoscopic Burch when compared with the open approach or trans-vaginal tape, the safety and relative efficacy of the laparoscopic procedure support its continued use. Laparoscopic sacrocolpopexy seems to yield comparable outcomes when compared with the open approach and is associated with a shorter hospitalization. Although laparoscopic paravaginal defect, cystocele, and rectocele repairs are technically feasible and may have a role as a concomitant procedure, a vaginal approach is more appropriate for an isolated operation.
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86
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Nicolson A, Adeyemo D. Colovaginal fistula: A rare long-term complication of polypropylene mesh sacrocolpopexy. J OBSTET GYNAECOL 2009; 29:444-5. [DOI: 10.1080/01443610902954360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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87
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Akhaddar A, Mahi M, Elouennass M, Niamane R, Elmoustarchid B, Boucetta M. Chronic pelvic pain reveals sacral osteomyelitis three years after abdominal hysterectomy. Surg Infect (Larchmt) 2009; 10:549-51. [PMID: 19656015 DOI: 10.1089/sur.2008.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Deep pelvic abscess is a well-known infective complication in gynecologic practice. However, sacral osteomyelitis has been reported rarely. We describe sacral infection presenting three years after abdominal hysterectomy and point out the difficulty in management. METHODS Case report and review of the pertinent literature. RESULTS A 46-year-old woman who had undergone abdominal hysterectomy three years before presented with an 8-month history of abdominopelvic pain recently intensifying in the sitting position without fever. Gynecologic, urinary, and rectal examination did not yield positive findings. An abdominopelvic computed tomography (CT) scan was normal except for sacral osteolysis. A neoplasm was suspected, but magnetic resonance imaging revealed an S2-S4 cystic collection with presacral extension. Neurologic examination did not show any focal deficits. A posterior CT-guided biopsy-aspiration yielded purulent fluid. Pathologic examination revealed inflammatory granulations without any malignant tumor. Abscess cultures grew three microorganisms. The patient's symptoms resolved completely after 3 months of antibiotic therapy. CONCLUSIONS Sacral osteomyelitis has not been reported previously after abdominal hysterectomy. Early diagnosis was made difficult by the absence of neurologic findings. Such postoperative infection should be considered after pelvic surgery. Minimally invasive needle aspiration may confirm the diagnosis and reduce the necessary extent of surgical intervention.
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Affiliation(s)
- Ali Akhaddar
- Department of Neurosurgery, Mohammed V Military Teaching Hospital, Rabat, Morocco.
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88
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Khong SY, Lam A. Laparoscopic removal of mesh used in pelvic floor surgery. J Minim Invasive Gynecol 2009; 16:592-4. [PMID: 19589732 DOI: 10.1016/j.jmig.2009.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 05/06/2009] [Accepted: 05/12/2009] [Indexed: 11/25/2022]
Abstract
Various meshes are being used widely in clinical practice for pelvic reconstructive surgery despite the lack of evidence of their long-term safety and efficacy. Management of complications such as mesh erosion and dyspareunia can be challenging. Most mesh-related complications can probably be managed successfully via the transvaginal route; however, this may be impossible if surgical access is poor. This case report demonstrates the successful laparoscopic removal of mesh after several failed attempts via the vaginal route.
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Affiliation(s)
- Su-Yen Khong
- Centre for Advanced Reproductive Endosurgery, St. Leonards, New South Wales, Australia.
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Nyarangi-Dix JN, Djakovic N, Kurosch M, Haferkamp A, Hohenfellner M. [Reconstructive pelvic surgery. Current status and future perspectives]. Urologe A 2009; 48:510-5. [PMID: 19421801 DOI: 10.1007/s00120-009-1979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pelvic organ prolapse is a widespread condition that especially affects women. There are a number of conservative and surgical therapeutic options. The choice of therapy should be individually made, depending on factors such as the grade of prolapse and concomitant secondary disorders as well as the age and general condition of the patient. This article presents current surgical options, analyzes recent studies, and offers future perspectives for reconstructive pelvic surgery.
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90
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Rardin CR, Washington BB. New Considerations in the Use of Vaginal Mesh for Prolapse Repair. J Minim Invasive Gynecol 2009; 16:360-4. [DOI: 10.1016/j.jmig.2009.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2008] [Revised: 01/04/2009] [Accepted: 01/08/2009] [Indexed: 10/20/2022]
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91
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Price N, Jackson SR. Advances in laparoscopic techniques in pelvic reconstructive surgery for prolapse and incontinence. Maturitas 2009; 62:276-80. [DOI: 10.1016/j.maturitas.2009.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Accepted: 01/19/2009] [Indexed: 10/21/2022]
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92
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Complete Mesh Expulsion as a Complication of Vaginally Assisted Laparoscopic Cervicosacropexy with Subtotal Hysterectomy: A Case Report. J Minim Invasive Gynecol 2009; 16:212-5. [DOI: 10.1016/j.jmig.2008.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Revised: 11/06/2008] [Accepted: 11/13/2008] [Indexed: 11/24/2022]
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Ganatra AM, Rozet F, Sanchez-Salas R, Barret E, Galiano M, Cathelineau X, Vallancien G. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol 2009; 55:1089-103. [PMID: 19201521 DOI: 10.1016/j.eururo.2009.01.048] [Citation(s) in RCA: 239] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Accepted: 01/27/2009] [Indexed: 01/05/2023]
Abstract
CONTEXT Pelvic organ prolapse (POP) is a common problem in women that causes morbidity and a decreased quality of life. Sacrocolpopexy can treat women with vaginal vault prolapse (VVP), multicompartmental POP, and/or a history of failed prolapse procedures. Abdominal sacrocolpopexy (ASC) is the gold standard for VVP and is superior to vaginal sacrocolpopexy, with fewer recurrent prolapses and less dyspareunia. Vaginal prolapse repairs, however, are often faster and offer patients a shorter recovery time. Laparoscopic sacrocolpopexy (LSC) aims to bridge this gap and to provide the outcomes of ASC with decreased morbidity. OBJECTIVE This review evaluates the recent literature on LSC as a therapy for POP. EVIDENCE ACQUISITION A PubMed search of the available English literature on LSC was performed. The reference lists of selected articles were reviewed, and additional on-topic articles were included. Some 50 articles were screened, 22 articles were selected, and the reported outcomes from 11 series are presented in this review. EVIDENCE SYNTHESIS Laparoscopic experience with POP has advanced tremendously, and LSC results from >1000 patients in 11 series support this. Conversion rates and operative times have decreased with increased experience. Mean operative time was 158 min (range: 96-286 min) with a 2.7% conversion rate (range: 0-11%) and a 1.6% early reoperation rate (range: 0-3.9%). With a mean follow-up of 24.6 mo (range: 11.4-66 mo), there was, on average, a 94.4% satisfaction rate, a 6.2% prolapse reoperation rate, and a 2.7% mesh erosion rate. Several centers have demonstrated that excellent outcomes with LSC are reproducible in terms of operative parameters, durable results, minimal complications, and high levels of patient satisfaction. CONCLUSIONS LSC upholds the outcomes of the gold standard ASC with minimal morbidity. Longer prospective and randomized trials are needed to confirm these results.
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Affiliation(s)
- Anjali M Ganatra
- Department of Urology, Institut Montsouris, Université Paris Descartes, Paris, France
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An update on the laparoscopic approach to urogynecology and pelvic reconstructive procedures. Curr Opin Obstet Gynecol 2008; 20:496-500. [PMID: 18797275 DOI: 10.1097/gco.0b013e32830fe3a3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW To review the evidence behind laparoscopic pelvic organ prolapse and urinary incontinence repair. RECENT FINDINGS A review of the recent literature continues to support the use of laparoscopy for colposuspension and sacral colpopexy as a viable alternative for open surgery. Polypropylene mid-urethral slings are comparable, if not better than laparoscopic Burch, though most data are short-term. The literature regarding other laparoscopic prolapse procedures, such as uterosacral ligament suspension, paravaginal defect repair, and rectocele repair is sparse. SUMMARY Short-term studies support the use of laparoscopy in urogynecology and reconstructive pelvic surgery. However, longer term studies are needed to confirm these findings.
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Current world literature. Adolescent and paediatric gynaecology. Curr Opin Obstet Gynecol 2008; 20:506-8. [PMID: 18797277 DOI: 10.1097/gco.0b013e328312c012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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96
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Paraiso MFR, Menefee S, Schaffer J, Varner E, Fitzgerald MP. Investigation of Surgical Procedures for Pelvic Organ Prolapse–The Mesh Dilemma. J Minim Invasive Gynecol 2008; 15:521-2. [DOI: 10.1016/j.jmig.2008.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 05/09/2008] [Accepted: 05/17/2008] [Indexed: 10/21/2022]
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