Risk factors for mesh/suture erosion following sacral colpopexy

Geoffrey W. Cundiff, Edward Varner, Anthony G. Visco, Halina M. Zyczynski, Charles W. Nager, Peggy A. Norton, Joseph Schaffer, Morton B. Brown, Linda Brubaker

Research output: Contribution to journalArticle

151 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)688.e1-688.e5
JournalAmerican journal of obstetrics and gynecology
Volume199
Issue number6
DOIs
StatePublished - Dec 2008

Keywords

  • CARE trial
  • expanded polytrafluroethylene (Gore-Tex, GORE Medical, Newark, DE)
  • hysterectomy
  • mesh erosion
  • sacral colpopexy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Cundiff, G. W., Varner, E., Visco, A. G., Zyczynski, H. M., Nager, C. W., Norton, P. A., Schaffer, J., Brown, M. B., & Brubaker, L. (2008). Risk factors for mesh/suture erosion following sacral colpopexy. American journal of obstetrics and gynecology, 199(6), 688.e1-688.e5. https://doi.org/10.1016/j.ajog.2008.07.029