ABSTRACT

Objective:

to determine the incidence of recurrent prolapse in different length categories of mesh along the vagina at sacrocolpopexy, performed in the division of urogynaecology in a university teaching hospital.

Patients and Methods:

A retrospective analysis was done from a urogynaecological data base, reviewing 301 patients who underwent sacrocolpopexy. They were analysed twice: firstly for the anterior mesh and secondly for the posterior mesh. Both anteriorly and posteriorly, they were categorized into three groups: with mesh from the vaginal vault, from the mid-vagina and from the vaginal introitus, both anteriorly and posteriorly, extending to the sacrum. The recurrence rate for prolapse was determined for each category.

Results:

Of the 301 patients, all were followed postoperatively for a mean period of 34 months (range 9-63 months). For each category, the recurrence rate for prolapse was as follows: anterior from vault (A1) 15.4% (n=26), from mid-vagina (A2) 8.3% (n=193), and from introitus to sacrum (A3) 2.4% (n=82). Posteriorly, the recurrence rates were as follows: from vault (P1) 23.7% (n=38), from mid-vagina (P2) 22.8% (n=44) and from introitus (P3) 3.2% (n=219). Statistically significant differences were found between A1 and A3, as well as between P1 and P3.

Conclusion:

With extension of the mesh along the vaginal walls during sacrocolpopexy, the incidence of recurrent prolapse decreased significantly.