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• W2124156639 abstract "No AccessJournal of UrologyNew Technology and Techniques1 Jun 2015Abdominal Mesh Sacrocolpopexy without Promontory Fixation: Initial Results of the Peritoneocolpopexy Technique Dominic Lee and Philippe E. Zimmern Dominic LeeDominic Lee More articles by this author and Philippe E. ZimmernPhilippe E. Zimmern More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.01.085AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present our experience and early outcomes using a new technique for mesh anchorage during open sacrocolpopexy called peritoneocolpopexy. Materials and Methods: A prospective review of patients from an institutional review board approved sacrocolpopexy database who underwent mesh peritoneocolpopexy was performed. Data included complications, validated questionnaires, pelvic organ prolapse quantification examination and associated outcomes. After placement of a Marlex® mesh anteriorly and posteriorly to the vaginal apex, the tail of the mesh is positioned in a peritoneal groove extending toward the promontory. The mesh is secured to surrounding tissues (peritoneum and fat underneath) with 2 running 2-zero V-Loc™ 180 (unidirectional barbed delayed absorbable) sutures placed on either side of the mesh tail well below the promontory. Results: Fourteen patients were identified from our prospective database. Mean age and followup were 60.5 years (range 28 to 82) and 19.6 months (range 7 to 38.3), respectively. Mean preoperative C-point was −2.7 (range 2 to −10) compared to −9.5 (range −8 to −12) postoperatively (p <0.003). No prolapse recurrence was noted. Mean operative time, blood loss and postoperative hospital stay were 238 minutes (range 160 to 300), 129 ml (range 20 to 900) and 3 days (range 1 to 6), respectively. Functional outcome improvement was statistically significant for total UDI-6—6 to 3 (p = 0.04), quality of life—4.1 to 2.1 (p <0.27) and IIQ-7—6 to 2 (p = 0.3), respectively. Conclusions: Peritoneocolpopexy performed reliably to correct symptomatic pelvic organ prolapse with satisfactory anatomical outcomes for apical support. Longer term followup is required to fully assess durability of repair. References 1 : Barbed suture tenorrhaphy: an ex vivo biomechanical analysis. Plast Reconstr Surg2009; 124: 1551. Google Scholar 2 : Tension leads to increased neutrophil accumulation and decreased laparotomy wound strength. Surgery1990; 107: 215. Google Scholar 3 : Utilization of a porcine model to demonstrate the efficacy of an absorbable barbed suture for dermal closure. UTSW2010; . Google Scholar 4 : Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse. BJU Int2009; 103: 1090. Google Scholar 5 : Life-threatening hemorrhage complicating sacral colpopexy. Am J Obstet Gynecol1981; 140: 836. Google Scholar 6 : Sacral colpopexy followed by refractory Candida albicans osteomyelitis and discitis requiring extensive spinal surgery. Obstet Gynecol2012; 120: 464. Google Scholar 7 : Lumbosacral osteomyelitis after robot-assisted total laparoscopic hysterectomy and sacral colpopexy. Int Urogynecol J2010; 21: 1569. Google Scholar 8 : Vascular and ureteral anatomy relative to the midsacral promontory. Am J Obstet Gynecol2013; 208: 486. Google Scholar 9 : Where do we place the sacrocolpopexy stitch? A magnetic resonance imaging investigation. Female Pelvic Med Reconstr Surg2013; 19: 31. Google Scholar 10 : Long-term success of abdominal sacral colpopexy using synthetic mesh. Am J Obstet Gynecol2002; 187: 1473. Google Scholar 11 : Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA2013; 309: 2016. Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 6June 2015Page: 2089-2094 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordspelvic organ prolapsepostoperative complicationstreatment outcomesMetricsAuthor Information Dominic Lee More articles by this author Philippe E. Zimmern More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2124156639 title "Abdominal Mesh Sacrocolpopexy without Promontory Fixation: Initial Results of the Peritoneocolpopexy Technique" @default.
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