Titanized polypropylene mesh in laparoscopic sacral colpopexy
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ORIGINAL ARTICLE
Titanized polypropylene mesh in laparoscopic sacral colpopexy Giuseppe Campagna 1 & Luigi Pedone Anchora 1 & Giovanni Panico 1 Mauro Cervigni 3 & Giovanni Scambia 1,4 & Alfredo Ercoli 5
&
Daniela Caramazza 1 & Martina Arcieri 2 &
Received: 16 May 2019 / Accepted: 3 October 2019 # The International Urogynecological Association 2019
Abstract Introduction This study investigated perioperative and mid-term clinical outcomes after laparoscopic sacrocolpopexy (LSCP) with light titanium-coated polypropylene (TCP) mesh in a large group of patients affected by International Continence Society stage II–IV pelvic organ prolapse (POP). Methods This multicenter retrospective study included 217 patients treated with LSCP using TCP mesh. We aimed to (1) analyze the intra- and postoperative complication rates according to the ICS/IUGA Complication Classification Code guidelines, (2) evaluate the anatomical results and (3) assess postoperative patient satisfaction with the Patient Global Impression Improvement questionnaire. Nonparametric Wilcoxon signed-rank tests, χ2 test and Fisher’s exact test were used where appropriate. Results The intraoperative complications were two (0.9%) cases of hemorrhage, two (0.9%) cases of incidental cystotomy and four (1.8%) cases of incidental colpotomy. During the postoperative follow-up, we recorded mesh exposure in 3 (1.4%) out of 217 patients. These 3 patients were from a group of 22 women who underwent vaginal opening during surgery, while in the remaining 195 patients without incidental colpotomy, no mesh exposure was observed (13.6% vs. 0.0%, p < 0.001). No failure of the apical compartment was observed, while 3 (1.4%) out of 217 patients experienced isolated anterior recurrence, and 1 (0.4%) patient had isolated posterior recurrence. All patients reported PGI-I scores ≥ 3, and 209 patients (96.3%) had a PGI-I score ≥ 2. Conclusions The use of light TCP mesh is safe and effective during LSCP for POP repair from both an anatomical and a functional point of view, posing a very low postoperative mesh-related complication risk. Keywords Laparoscopic sacrocolpopexy . Light titanium-coated polypropylene mesh . Pelvic organ prolapse . Perioperative morbidity . Postoperative patient satisfaction
Introduction * Giovanni Panico [email protected] 1
Department of Female and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Women’s Health Area, Rome, Italy
2
Department of Obstetrics and Gynecology, Ospedale Maggiore della Carità Università degli Studi del Piemonte Orientale, Novara, Italy
3
Clinica Paideia, Rome, Italy
4
Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
5
PID Ginecologia Oncologica e Chirurgia Ginecologica Miniinvasiva, Università degli studi di Messina, Policlinico G. Martino, Messina, Italy
Pelvic organ prolapse (POP) is a dynamic disorder related to damage of the pelvic support mechanism. Treatment for POP has become increasingly important in women’s he
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