Risk factors for mesh/suture erosion following sacral colpopexy
Open accessAbstract
Objective The purpose of this study was to identify risks for mesh/suture erosions following abdominal sacral colpopexy (ASC).Study design We analyzed demographic, perioperative variables, and erosion status in 322 participants in the Colpopexy and Urinary Reduction Efforts study 2 years after sacral colpopexy.Results The predominant graft used was synthetic mesh: woven polyester (Mersilene; Ethicon, Inc, Somerville, NJ) (42%) or polypropylene (48%). Twenty subjects (6%) experienced mesh/suture erosion. Unadjusted risk factors for mesh/suture erosion were expanded polytrafluroethylene (ePTFE) mesh (ePTFE 4/21 [19%] vs non-ePTFE 16/301 [5%]; odds ratio [OR], 4.2), concurrent hysterectomy (OR, 4.9), and current smoking (OR, 5.2). Of those with mesh erosion, most affected women (13/17) underwent at least 1 surgery for partial or total mesh removal. Two were completely resolved, 6 had persistent problems, and 5 were lost to follow-up. No resolution was documented in the 4 women who elected observation.Conclusion Expanded PTFE mesh should not be used for sacral colpopexy. Concurrent hysterectomy and smoking are modifiable risks for mesh/suture erosion.
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In the CARE trial, concurrent hysterectomy was associated with a fivefold increase in the risk of mesh/suture erosion compared with those without hysterectomy.
“In the CARE trial, which included 322 women undergoing SC with complete 2-year follow-up, concurrent hysterectomy was associated with a fivefold increase in the risk of mesh/suture erosion compared with those without hysterectomy [8].”
From Mesh Exposure After Laparoscopic Sacrocolpopexy with Concomitant Total Hysterectomy or Uterine Preservation: A Retrospective Cohort Study (2026) · cites this paper as [8]
The Results report 322 CARE participants who underwent sacrocolpopexy and an association between concurrent hysterectomy and mesh/suture erosion (OR 4.9, approximately fivefold). But the citing sentence's claim of complete two-year follow-up for all 322 is not supported: the Results say 93% completed aspects of the assessment and 74 did not have a pelvic examination at 24 months. (LLM, conf=0.93)
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- Authors
- Cundiff, G. W., Varner, E., Visco, A. G., Zyczynski, H. M., Nager, C. W., Norton, P. A., Schaffer, J., Brown, M. B., & Brubaker, L.
- Affiliations
- University of British Columbia (CA)
- University of Alabama at Birmingham (US)
- University of North Carolina at Chapel Hill (US)
- University of Pittsburgh (US)
- University of California San Diego (US)
- University of Utah (US)
- The University of Texas Southwestern Medical Center (US)
- University of Michigan (US)
- Loyola University Chicago (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2008-12
- Volume
- 199
- Issue
- 6
- Pages
- 688.e1-688.e5
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC2859033
- OpenAlex
- W2034559943
- Cited by
- 228
- References
- 13
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 6 · 2023: 5 · 2022: 13 · 2021: 11 · 2020: 18 · 2019: 12 · 2018: 12 · 2017: 16 · 2016: 18 · 2015: 8 · 2014: 19 · 2013: 27 · 2012: 19
- FWCI
- 6.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK060380)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U10HD041268, U10HD041261, U01HD041249, U10HD041263, U10HD041267, U10HD041248, U10HD041269, U10HD041250, UG1HD041267)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- sacrocolpopexy, mesh erosion, suture erosion, expanded polytetrafluoroethylene mesh, risk factors, smoking, mesh removal, pelvic organ prolapse surgery
- MeSH terms
- Adult, Aged, Colposcopy, Female, Follow-Up Studies, Humans, Middle Aged, Prosthesis Design, Prosthesis Failure, Reoperation, Risk Factors, Severity of Illness Index, Gynecologic Surgical Procedures, Surgical Mesh, Sutures, Urinary Incontinence, Stress, Uterine Prolapse
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