Laparoscopic sacrocolpopexy (LSCP) using an ultra-lightweight polypropylene mesh

Lucy Dwyer; Wilfred Kumakech; Karen Ward; Fiona Reid; Anthony Smith

doi:10.1016/j.eurox.2019.100008

Laparoscopic sacrocolpopexy (LSCP) using an ultra-lightweight polypropylene mesh

Eur J Obstet Gynecol Reprod Biol X. 2019 Feb 8:2:100008. doi: 10.1016/j.eurox.2019.100008. eCollection 2019 Apr.

Authors

Lucy Dwyer¹, Wilfred Kumakech¹, Karen Ward¹, Fiona Reid¹, Anthony Smith¹

Affiliation

¹ The Warrell Unit, Saint Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom.

Abstract

Objectives: Since 2005 the preferred method for surgical treatment of vaginal vault prolapse within the department has been laparoscopic sacrocolpopexy with an ultra-lightweight polypropylene mesh. The study aimed to explore the functional and anatomical outcomes and mesh adverse events of women following this procedure.

Study design: All women who had a Laparoscopic Sacrocolpopexy (LSCP) using an ultra-lightweight (19 g/m²) polypropylene mesh in two units in the North West of England between March 2005 and January 2013 (n = 238) were invited to participate in the study.Functional outcome data was collected using the Patient Global Impression Questionnaire (PGI-I), the Pelvic Floor Distress Inventory (PFDI-20) and the Electronic Personal Assessment Questionnaire (EPAQ) post-operatively. Anatomical outcome was assessed by Pelvic Organ Prolapse Quantification System (POP-Q) measurement. A mesh palpability assessment was performed and any mesh complications were recorded using the International Continence Society/International Urogynecology Association (ICS/IUGA) classification system. The results were compared to those in our previously published series using the same surgical technique but a standard weight mesh (82.5 g/m²).

Results: 89% of participants reported that they felt their post-operative condition had improved. POP-Q results revealed that the median position of C changed from -3 pre-op to -7 post-operatively. Mesh was palpable during vaginal examination in only 3 women (3%). No mesh extrusion was identified during the study.

Conclusions: The study demonstrates that LSCP performed with an ultra-lightweight polypropylene mesh improves women's functional and anatomical symptoms and appears to have a low risk of mesh extrusion.

Keywords: EPAQ, Electronic Personal Assessment Questionnaire; ICS/IUGA, International Continence Society/International Urogynecology Association; LSCP; LSCP, laparoscopic sacrocolpopexy; Laparoscopic sacrocolpopexy; PFDI-20, Pelvic Floor Distress Inventory; PGI-I, Patient Global Impression Questionnaire; POP-Q, Pelvic Organ Prolapse Quantification System; Ultra-lightweight polypropylene mesh; Vault prolapse.