Mesh exposure following minimally invasive sacrocolpopexy: a narrative review
Abstract
Introduction and hypothesis Sacrocolpopexy is considered mainstay treatment for apical or vaginal vault prolapse and is currently most often performed via a minimally invasive approach. Although mesh-related complications after this procedure are uncommon, mesh exposure can have an important impact on the patient's quality of life. Our objective is to perform a literature review on this complication post laparoscopic or robotic sacrocolpopexy.Methods Web of Science and MEDLINE databases were searched for relevant articles published between 2005 and 2021. We retrieved 272 articles of which 83 ultimately were withheld.Results Minimally invasive sacrocolpopexy (MISC) implies a low risk of mesh exposure, which is currently estimated at 3.5%. Literature however is marked by substantial methodological heterogeneity. Controversy remains in the debate over prevention of mesh exposure after MISC. Performing a concomitant total hysterectomy is associated with an increased risk compared to subtotal hysterectomy or hysteropexy. Treatment of mesh exposure is challenging as guidelines are lacking. Although supported by few prospective data, patients with asymptomatic mesh exposure are managed conservatively. Surgical intervention, preferentially performed by an experienced pelvic surgeon, is indicated in symptomatic patients.Conclusions Mesh exposure is often undiagnosed and remains untreated. There is a gap in evidence exploring risk factors for mesh-related complications and efficient measures for reducing them. Choosing the best treatment option is still difficult. Management should be individualized and optimized at the time of diagnosis. Lack of acknowledgement and experience can result in increased morbidity.
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A recent literature review estimated that the overall incidence of mesh exposure after minimally invasive SCP was low (average incidence, 3.5%; median follow-up, 6-86 months).
“Regarding postoperative complications, a recent literature review estimated that the overall incidence of mesh exposure after minimally invasive SCP was low (average incidence, 3.5%; median follow‐up, 6–86 months) [21].”
From Composite Failure Associated With Sacrohysteropexy and Sacrocolpopexy With Supracervical Hysterectomy for Advanced Pelvic Organ Prolapse (2025) · cites this paper as [21]
The rate of mesh exposure after sacrocolpopexy varies from 3% to 10%.
“The rate of mesh exposure after SC varies from 3% to 10% [7]”
From Mesh Exposure After Laparoscopic Sacrocolpopexy with Concomitant Total Hysterectomy or Uterine Preservation: A Retrospective Cohort Study (2026) · cites this paper as [7]
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Şanverdi, İ., Kılıççı, Ç., Polat, M., Özkaya, E., Kılıç, S. G., Dizdar, M., & Karateke, A. (2017) · Journal of Turkish Society of Obstetric and Gynecology · doi:10.4274/tjod.96641 · Cited by 6 · see citing works
Laparoscopic sacrocolpopexy (LSCP) using an ultra-lightweight polypropylene mesh
Dwyer, L., Kumakech, W., Ward, K., Reid, F. M., & Smith, A. R. B. (2019) · European Journal of Obstetrics & Gynecology and Reproductive Biology X · doi:10.1016/j.eurox.2019.100008 · Cited by 6 · see citing works
Management of Vaginal Mesh Exposures Following Female Pelvic Reconstructive Surgery
Kisby, C. K., & Linder, B. J. (2020) · Current Urology Reports · doi:10.1007/s11934-020-01002-0 · Cited by 5 · see citing works
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van Oudheusden, A. M. J., Eissing, J., Terink, I. M., Vink, M. D. H., van Kuijk, S. M. J., Bongers, M. Y., & Coolen, A.-L. W. M. (2022) · International Urogynecology Journal · doi:10.1007/s00192-022-05350-y · Cited by 28 · see citing works
Chen, Y., Zhou, Y., Tan, L., Chen, S., Wu, C., Liang, Y., Sun, N., & Liu, J. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e19698 · Cited by 19 · see citing works
Tius, V., Arcieri, M., Taliento, C., Pellecchia, G., Capobianco, G., Simoncini, T., Panico, G., Caramazza, D., Campagna, G., Driul, L., et al. (2025) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15891 · Cited by 16 · see citing works
Long-term mesh exposure after minimally invasive total hysterectomy and sacrocolpopexy
Matthews, C. A., Myers, E. M., Henley, B. R., Kenton, K. S., Weaver, E., Wu, J. M., & Geller, E. J. (2022) · International Urogynecology Journal · doi:10.1007/s00192-022-05388-y · Cited by 15 · see citing works
Outcomes of robotic sacrocolpopexy
Oh, S., & Shin, J. (2023) · Obstetrics & Gynecology Science · doi:10.5468/ogs.23073 · Cited by 13 · see citing works
Lu, Z., Chen, Y., Wang, X., Li, J., Chen, Y., Feng, Y., Hua, K., & Hu, C. (2022) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2022.08.001 · Cited by 13 · see citing works
Mozon, A.-O., Kim, J. H., & Lee, S. R. (2024) · Obstetrics & Gynecology Science · doi:10.5468/ogs.23226 · Cited by 10 · see citing works
Lombisani, A., Tius, V., Ferraro, C., Arcieri, M., Vacca, L., Caramazza, D., Restaino, S., Simoncini, T., Capobianco, G., Ercoli, A., et al. (2025) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-025-08210-4 · Cited by 6 · see citing works
Minimally Invasive Total Versus Supracervical Hysterectomy With Sacrocolpopexy
Giugale, L. E., Ruppert, K. M., Muluk, S. L., Clark, S. M. G., Bradley, M. S., Wu, J. M., & Matthews, C. A. (2024) · Urogynecology · doi:10.1097/spv.0000000000001530 · Cited by 4 · see citing works
Shenhar, C., & Goldman, H. B. (2024) · International Urogynecology Journal · doi:10.1007/s00192-024-05955-5 · Cited by 4 · see citing works
Willison, N., McPhail, C., Šeman, E. I., Taheri, M., Aryan, P., Nguyen, T. T. T., Yi, J., Abbott, D., Dune, T. J., & Behnia‐Willison, F. (2025) · International Urogynecology Journal · doi:10.1007/s00192-025-06123-z · Cited by 4 · see citing works
Evaluation of lower urinary tract symptoms and sexual function after laparoscopic sacrocolpopexy
Hsieh, T.-H., Chang, S., Lo, T., Lin, Y., Hsu, L.-T., & Liang, C. (2025) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2024.10.026 · Cited by 4 · see citing works
Robotic sacrocolpopexy: a game worth playing? A critical literature analysis
Jamaleddine, H. M., Khalil, N., Aoun, R., & Atallah, D. M. (2025) · Frontiers in Surgery · doi:10.3389/fsurg.2025.1561976 · Cited by 7 · see citing works
Sato, H., Otsuka, S., Sugita, K., Abe, H., & Tsukada, S. (2025) · Neurourology and Urodynamics · doi:10.1002/nau.25640 · Cited by 2 · see citing works
“Regarding postoperative complications, a recent literature review estimated that the overall incidence of mesh exposure after minimally invasive SCP was low (average incidence, 3.5%; median follow ‐ up, 6 – 86 months) [21].”
InfluentialWard, K., Bautrant, É., Khatri, G., Love‐Jones, S., Glanc, P., Korte, C., Germano, N., Mourad, S., & Hashim, H. (2024) · Continence · doi:10.1016/j.cont.2024.101718 · Cited by 2 · see citing works
Cundiff, G. W., Sanaee, M., & Schulz, J. A. (2024) · Continence · doi:10.1016/j.cont.2024.101318 · Cited by 2 · see citing works
Yin, R., Zhang, Y., Xiao, Y., Chen, J., & Zhu, L. (2026) · International Urogynecology Journal · doi:10.1007/s00192-026-06554-2 · Cited by 1 · see citing works
“We believe that this is related to the vaginal bacteria contamination introduced by the opening of the vaginal cuff [7].”
Sato, H., Otsuka, S., Kenji, S., Abe, H., & Tsukada, S. (2025) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2025.114841 · Cited by 1 · see citing works
Incidence of uterine cancer after supracervical hysterectomy
Neveu, M. L., SIMMONS, A., Rhodes, S. P., Crescenze, I. M., & Sheyn, D. D. (2026) · Minerva Obstetrics and Gynecology · doi:10.23736/s2724-606x.26.05828-8 · Cited by 1 · see citing works
Rotem, R., Alkeesh, Y., Hirsch, A., Ben‐Shachar, I., & Marcus-Braun, N. (2025) · International Urogynecology Journal · doi:10.1007/s00192-024-06037-2 · Cited by 1 · see citing works
The Effect of Concomitant Hysterectomy Route on Robotic Sacrocolpopexy Outcomes
Swallow, C. H., İmamoğlu, M., Imamoglu, A. G., Xu, X. J., & Harmanli, O. (2025) · Urogynecology · doi:10.1097/spv.0000000000001659 · Cited by 1 · see citing works
Surgical treatment for apical vaginal prolapse
van Oudheusden, A. M. J. (2023) · doi:10.26481/dis.20231010ao
Netzchirurgie in der Gynäkologie
Hübner, M. (2024) · Frauenheilkunde up2date · doi:10.1055/a-2040-9942
Individualized treatment for posthysterectomy vaginal eversion: Case report and literature review
Pantović, S., Dotlić, J., Stefanović, K., Milošević, B., Pantović, K., & Likić-Ladjević, I. (2024) · Srpski medicinski casopis Lekarske komore · doi:10.5937/smclk5-51819
Wu, H.-M., Xu, N., Li, Y.-H., Luo, Z.-G., Xiong, R., Li, M., & Li, M. (2026) · BMC Women s Health · doi:10.1186/s12905-026-04515-x
Quy, P. T., Lacorre, A., Mathonnet, M., Descazeaud, A., & Gauthier, T. (2026) · Journal of Gynecology Obstetrics and Human Reproduction · doi:10.1016/j.jogoh.2026.103233
Ülger, G., Yıldız, H., Guven, I., & Aytan, H. (2026) · Bulletin of the National Research Centre/Bulletin of the National Research Center · doi:10.1186/s42269-026-01466-z
Ragni, E., Pirš, T., Khatib, G., & Starič, K. D. (2026) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2026.07.013
- Authors
- Deblaere, S., Hauspy, J., & Hansen, K.
- Affiliations
- Ghent University Hospital (BE)
- GZA Ziekenhuizen Campus Sint-Augustinus (BE)
- Corresponding author
- Deblaere, Stephanie
- ORCID
- Deblaere, Stephanie
- Venue
- International Urogynecology Journal
- Published
- 2022-02-28
- Volume
- 33
- Issue
- 10
- Pages
- 2713-2725
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- OpenAlex
- W4214598465
- Cited by
- 28
- References
- 88
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 9 · 2023: 3 · 2022: 3
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Urogynecology Journal (publishedVersion)
- PubMed (publishedVersion)
- 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 exposure, sacrocolpopexy, minimally invasive surgery, laparoscopic sacrocolpopexy, robotic sacrocolpopexy, vaginal vault prolapse, apical pelvic organ prolapse, mesh complications, total hysterectomy, subtotal hysterectomy, hysteropexy
- MeSH terms
- Female, Humans, Laparoscopy, Prospective Studies, Quality of Life, Gynecologic Surgical Procedures, Surgical Mesh, Vagina, Treatment Outcome, Pelvic Organ Prolapse
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