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Risk factors for mesh/suture erosion following sacral colpopexy.

Publication ,  Journal Article
Cundiff, GW; Varner, E; Visco, AG; Zyczynski, HM; Nager, CW; Norton, PA; Schaffer, J; Brown, MB; Brubaker, L; Pelvic Floor Disorders Network
Published in: Am J Obstet Gynecol
December 2008

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.

Duke Scholars

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

December 2008

Volume

199

Issue

6

Start / End Page

688.e1 / 688.e5

Location

United States

Related Subject Headings

  • Uterine Prolapse
  • Urinary Incontinence, Stress
  • Sutures
  • Surgical Mesh
  • Severity of Illness Index
  • Risk Factors
  • Reoperation
  • Prosthesis Failure
  • Prosthesis Design
  • Obstetrics & Reproductive Medicine
 

Citation

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Cundiff, G. W., Varner, E., Visco, A. G., Zyczynski, H. M., Nager, C. W., Norton, P. A., … Pelvic Floor Disorders Network. (2008). Risk factors for mesh/suture erosion following sacral colpopexy. Am J Obstet Gynecol, 199(6), 688.e1-688.e5. https://doi.org/10.1016/j.ajog.2008.07.029
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

December 2008

Volume

199

Issue

6

Start / End Page

688.e1 / 688.e5

Location

United States

Related Subject Headings

  • Uterine Prolapse
  • Urinary Incontinence, Stress
  • Sutures
  • Surgical Mesh
  • Severity of Illness Index
  • Risk Factors
  • Reoperation
  • Prosthesis Failure
  • Prosthesis Design
  • Obstetrics & Reproductive Medicine