Post-operative outcomes associated with anterior mesh location after laparoscopic sacrocolpopexy.

Abstract

Objective To investigate the relationship between the position of the anterior mesh, measured by ultrasound through the Bladder neck - Mesh Distance technique and the surgical outcomes after laparoscopic sacrocolpopexy (SCP) for apical prolapse. Study design: Retrospective analysis of prospectively collected data in a tertiary care hospital. Between January 2019 and September 2019, 63 women who underwent laparoscopic SCP due to apical prolapse were included. Bladder neck - Mesh Distance was measured immediately after surgery. The pelvic floor was evaluated using the Pelvic Organ Prolapse Quantification (POP-Q) System before, one month, and 2.7 years (mid-term) after the surgery. Postoperative stress urinary incontinence (SUI) and Patient Global Impression of Improvement (PGI-I) scores were also assessed. The correlation between Bladder neck - Mesh Distance and the postoperative outcomes was investigated using the Spearman rank correlation coefficient. Results At mid-term follow-up visit, Bladder neck - Mesh Distance was inversely correlated with the correction of apical prolapse and postoperative SUI. No correlation was detected with the anterior compartment prolapse correction. PGI-I scores were high in all patients at mid-term follow-up, irrespective of Bladder neck - Mesh Distance values. Conclusion The shorter the Bladder neck - Mesh Distance, the better the outcome for apical compartment repair. Bladder neck - Mesh Distance had no correlation with the anterior anatomical correction. Shorter Bladder neck - Mesh Distance values were positively correlated to better PGI-I scores and a higher risk of SUI.