Complications of laparoscopic sacropexy: as harmless as they seem?

• Main Author: Campos,Sara
• Publication Date: 2016
• Other Authors: Billone,Valentina, Durão,Marta, Beguinot,Marie, Bourdel,Nicolas, Rabischong,Benoît, Canis,Michel, Botchorishvili,Revaz
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302016000100005
• topic: Sacropexy; Complications; Prolapse; Mesh; Laparoscopy

Overview and aims: To analyze all patients needing surgical treatment for complications related to laparoscopic sacropexy and their clinical management. Study Design: Case series. Population: All women submitted to surgical treatment of complications related to laparoscopic sacropexy for pelvic organ prolapse treatment on a tertiary referral center (university hospital), from January 1998 to December 2013. Methods: Retrospective analysis of the patients' clinical records. Results: Thirty-three patients were submitted to surgery due to complications related to the procedure, some more than once, with more than one complication registered. There were 6 general surgical complications (2 hematomas, 2 peritonitis, 1 mechanical bowel obstruction due to small bowel incarceration and 1 vaginal wall necrosis) and 34 mesh related complications (27 vaginal mesh exposures, 4 periprosthetic abscesses, 1 vesicovaginal fistula, 1 rectovaginal fistula and 1 posterior mesh retraction). Mean time between prolapse surgery and the first surgery for complication treatment was 18.2 ± 25.3 months (3 days - 131 months). The average number of surgeries needed was 1.8 ± 1.5(1- 6). Conclusions: Surgeons should be aware of the risk factors for complications. Longterm complications should not be neglected. After a mesh placement, patients are at risk for requiring multiple surgeries to resolve complications, which can be challenging, ineffective and expose patient to new ones.