Incidence and management of abdominal sacrocolpopexy mesh erosions

This study was undertaken to evaluate the occurrence and management of mesh erosions in patients undergoing abdominal sacrocolpopexy. A retrospective chart review of the abdominal sacrocolpopexy procedure (n = 92) between 1997 and 2003 was performed. Patients with mesh erosion were identified. Incid...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2005-06, Vol.192 (6), p.1956-1962
Main Authors: Begley, J. Sean, Kupferman, Susan P., Kuznetsov, Dimitri D., Kobashi, Kathleen C., Govier, Fred E., McGonigle, Kathryn F., Muntz, Howard G.
Format: Article
Language:English
Subjects:
Abdomen - surgery
Abdominal sacral colpopexy
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Erosion
Female
Graft
Gynecologic Surgical Procedures - adverse effects
Gynecology. Andrology. Obstetrics
Humans
Incidence
Medical Records
Medical sciences
Mesh
Middle Aged
Prostheses and Implants
Prosthesis Failure
Prosthesis Implantation - adverse effects
Retrospective Studies
Sacrocolpopexy
Surgical Mesh
Uterine Prolapse - epidemiology
Uterine Prolapse - etiology
Uterine Prolapse - surgery
Washington - epidemiology
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Summary:This study was undertaken to evaluate the occurrence and management of mesh erosions in patients undergoing abdominal sacrocolpopexy. A retrospective chart review of the abdominal sacrocolpopexy procedure (n = 92) between 1997 and 2003 was performed. Patients with mesh erosion were identified. Incidence by graft type and treatment required for erosion resolution was analyzed with χ 2 and Fisher exact test. Erosions occurred in 7.6 % (7/92). Erosions were identified only in patients with Gore-Tex (3/33, 9%) or silicone-coated mesh (4/21, 19%) compared with none of 38 patients with polypropylene mesh (n = 24) or fascia (n = 14) grafts ( P = .068.). Partial excision of exposed graft resolved all 3 Gore-Tex erosions, compared with none of the silicone-coated mesh erosions ( P = .03). Complete graft removal was required to resolve silicone-coated mesh erosions. We observed a high rate of erosion with Gore-Tex and silicone-coated mesh. Partial graft excision was adequate for Gore-Tex erosions, but complete graft removal was necessary to resolve erosions associated with silicone-coated mesh.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2005.02.062