Long-term mesh complications and reoperation after laparoscopic mesh sacrohysteropexy: a cross-sectional study
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Introduction and hypothesis: The paucity of long-term safety and efficacy data to support laparoscopic mesh sacrohysteropexy is noteworthy given concerns about the use of polypropylene mesh in pelvic floor surgery. This study is aimed at determining the incidence of mesh-associated complications and reoperation following this procedure. Methods: This was a cross-sectional postal questionnaire study of women who underwent laparoscopic mesh sacrohysteropexy between 2010 and 2018. Potential participants were identified from surgical databases of five surgeons at two tertiary urogynaecology centres in the UK. The primary outcome was patient-reported mesh complication requiring removal of hysteropexy mesh. Secondary outcomes included other mesh-associated complications, reoperation rates and Patient Global Impression of Improvement (PGI-I) in prolapse symptoms. Descriptive statistics and Kaplan–Meier survival analyses were used. Results: Of 1,766 eligible participants, 1,121 women responded (response proportion 63.5%), at a median follow-up of 46 months. The incidence of mesh complications requiring removal of hysteropexy mesh was 0.4% (4 out of 1,121). The rate of chronic pain service use was 1.8%, and newly diagnosed systemic autoimmune disorders was 5.8%. The rate of reoperation for apical prolapse was 3.7%, and for any form of pelvic organ prolapse it was 13.6%. For PGI-I, 81.4% of patients were “much better” or “very much better”. Conclusions: Laparoscopic mesh sacrohysteropexy has a low incidence of reoperation for mesh complications and apical prolapse, and a high rate of patient-reported improvement in prolapse symptoms. With appropriate clinical governance measures, the procedure offers an alternative to vaginal hysterectomy with apical suspension. However, long-term comparative studies are still required.
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Laparoscopic mesh sacrohysteropexy appears to be safe.
“Laparoscopic mesh sacrohysteropexy (LSH) is one such uterine-preserving alternative that appears to be safe [11], yet comparative data supporting its use remain sparse.”
From Laparoscopic sacrohysteropexy versus vaginal hysterectomy and apical suspension: 7-year follow-up of a randomized controlled trial (2022) · cites this paper as [11]
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- Authors
- Izett-Kay, M. L., Aldabeeb, D., Kupelian, A. S., Cartwright, R., Cutner, A. S., Jackson, S., Price, N., & Vashisht, A.
- Affiliations
- University College Hospital (GB)
- University College London (GB)
- John Radcliffe Hospital (GB)
- Corresponding author
- Izett-Kay, Matthew L.
- Venue
- International Urogynecology Journal
- Published
- 2020-07-03
- Volume
- 31
- Issue
- 12
- Pages
- 2595-2602
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- PMC
- PMC7679361
- OpenAlex
- W3040596860
- Cited by
- 26
- References
- 32
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 5
- FWCI
- 3.01
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- International Urogynecology Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Funders
- University College London
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Keywords
- mesh removal, reoperation, pelvic organ prolapse, apical prolapse, chronic pelvic pain, long-term outcomes, patient-reported outcomes
- MeSH terms
- Cross-Sectional Studies, Female, Humans, Laparoscopy, Reoperation, Gynecologic Surgical Procedures, Surgical Mesh, Treatment Outcome, Pelvic Organ Prolapse
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