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• W3205274693 abstract "Study Objective Determine the risk difference of mesh exposure rates at 1-year following minimally invasive sacrocolpopexy (MISC) with and without concomitant total hysterectomy utilizing lightweight Y-mesh. Design Retrospective cohort, 2016-2019. Setting Single academic institution. Patients or Participants Women who underwent MISC and had 1-year in-office follow-up. Excluded if history of prior mesh augmented prolapse repair or supracervical hysterectomy. Interventions Women who underwent MISC with or without concomitant total hysterectomy were compared. Measurements and Main Results Cohort included 259 women, mean age was 63.6±9.2 years, BMI 27.1 kg/m2, 89% were post-menopausal, 46% sexually active, 18% had a history of prior FPMRS surgery. MISC + total hysterectomy (n=126) v. MISC alone (n=133). The overall rate of mesh exposure was 3/259 (1.2%, 95% CI, 0.2% - 3.4%). All mesh exposures were in the total hysterectomy group, two with absorbable suture, one with permanent suture for graft attachment. The risk difference of mesh exposure was 2.4% (95% CI, -0.5% - 6.9%) for those who underwent MISC + total hysterectomy v. MISC alone and was not significantly different from zero. The NSQIP 30-day complication rate was higher in the total hysterectomy group 14.3% v. 2.3% (p <0.01), however, this difference is attributed to the increased rate of urinary tract infections (total hysterectomy group n=14, post-hysterectomy group n=0). There were no mortalities and 30-day readmission rates did not differ between groups 1.5% v. 1.6% (p = 1.0). Rate of recurrent prolapse, defined as ≥ Stage 2 on clinical examination, was not statistically different between groups, MISC+ total hysterectomy 12.7 % v. MISC alone 21.8 % (p=0.06). There was one reoperation for prolapse, which was in the MISC alone group (isolated posterior repair). Conclusion The rate of mesh exposure one year after MISC with lightweight Y-mesh is low at 1.2%, with no statistically significant difference between those who underwent MISC with or without concomitant total hysterectomy. Determine the risk difference of mesh exposure rates at 1-year following minimally invasive sacrocolpopexy (MISC) with and without concomitant total hysterectomy utilizing lightweight Y-mesh. Retrospective cohort, 2016-2019. Single academic institution. Women who underwent MISC and had 1-year in-office follow-up. Excluded if history of prior mesh augmented prolapse repair or supracervical hysterectomy. Women who underwent MISC with or without concomitant total hysterectomy were compared. Cohort included 259 women, mean age was 63.6±9.2 years, BMI 27.1 kg/m2, 89% were post-menopausal, 46% sexually active, 18% had a history of prior FPMRS surgery. MISC + total hysterectomy (n=126) v. MISC alone (n=133). The overall rate of mesh exposure was 3/259 (1.2%, 95% CI, 0.2% - 3.4%). All mesh exposures were in the total hysterectomy group, two with absorbable suture, one with permanent suture for graft attachment. The risk difference of mesh exposure was 2.4% (95% CI, -0.5% - 6.9%) for those who underwent MISC + total hysterectomy v. MISC alone and was not significantly different from zero. The NSQIP 30-day complication rate was higher in the total hysterectomy group 14.3% v. 2.3% (p <0.01), however, this difference is attributed to the increased rate of urinary tract infections (total hysterectomy group n=14, post-hysterectomy group n=0). There were no mortalities and 30-day readmission rates did not differ between groups 1.5% v. 1.6% (p = 1.0). Rate of recurrent prolapse, defined as ≥ Stage 2 on clinical examination, was not statistically different between groups, MISC+ total hysterectomy 12.7 % v. MISC alone 21.8 % (p=0.06). There was one reoperation for prolapse, which was in the MISC alone group (isolated posterior repair). The rate of mesh exposure one year after MISC with lightweight Y-mesh is low at 1.2%, with no statistically significant difference between those who underwent MISC with or without concomitant total hysterectomy." @default.
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• W3205274693 date "2021-11-01" @default.
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• W3205274693 title "Minimally Invasive Sacrocolpopexy Mesh Exposure Rates with and without Concomitant Total Hysterectomy" @default.
• W3205274693 doi "https://doi.org/10.1016/j.jmig.2021.09.469" @default.
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