Mesh erosion in abdominal sacral colpopexy with and without concomitant hysterectomy

Am J Obstet Gynecol. 2006 May;194(5):1418-22. doi: 10.1016/j.ajog.2006.01.051.

Abstract

Objective: The purpose of this study was to examine risk factors for mesh erosion, including concomitant hysterectomy, in abdominal sacral colpopexies.

Study design: We conducted a retrospective cohort study of 313 women who underwent an abdominal sacral colpopexy. Data regarding patient demographics, operative techniques, length of follow-up, postoperative complications, and mesh erosion were collected.

Results: Of 313 subjects, 101 (32.3%) had concomitant hysterectomies and 212 (67.7%) had had previous hysterectomies. The overall rate of mesh erosion was 5.4%. In bivariate analysis, concomitant hysterectomy was not associated with erosion (6.9% vs 4.7% previous hysterectomy, P = .42); however, estrogen therapy was an effect modifier. In women on estrogen, hysterectomy (OR 4.9, CI 1.2-19.7) and anterior imbrication (OR 5.6, CI 1.1-28.6) were associated with mesh erosion. No risk factors were identified in women not on estrogen.

Conclusion: In women on estrogen therapy, hysterectomy was associated with mesh erosion in abdominal sacral colpopexy.

MeSH terms

  • Aged
  • Cohort Studies
  • Equipment Failure
  • Estrogen Replacement Therapy / adverse effects
  • Female
  • Humans
  • Hysterectomy / adverse effects*
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Surgical Mesh / adverse effects*
  • Survival Analysis
  • Suture Techniques*
  • Uterine Prolapse / surgery*