Cited by 28Pelvic floor disorders treatmentsUterine Myomas and TreatmentsHernia repair and management

Mesh exposure following minimally invasive sacrocolpopexy: a narrative review

Deblaere, Stephanie, Hauspy, Jan, Hansen, Karen·2022·International Urogynecology Journal

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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Crossref · 10.1007/s00192-021-04998-2

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88 of 88 references verified0 citation errors · 0 not checkable

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Authors
Deblaere, S., Hauspy, J., & Hansen, K.
Affiliations
  • Ghent University Hospital (BE)
  • GZA Ziekenhuizen Campus Sint-Augustinus (BE)
Corresponding author
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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