Medium‐term outcome of laparoscopic sacrocolpopexy using polivinylidene fluoride as compared to a hybrid polyglecaprone and polypropylene mesh: A matched control study

• Published in: Neurourology and urodynamics Vol. 38; no. 7; pp. 1874 - 1882
• Main Authors: Callewaert, Geertje, Housmans, Susanne, Cattani, Laura, Pacquée, Stefaan, D'Hoore, André, Wyndaele, Jan, Aa, Frank, Deprest, Jan
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.09.2019
• Subjects: Aged; Constipation; Constipation - etiology; Female; Fluorides; Humans; Laparoscopy; Laparoscopy - adverse effects; Middle Aged; Patient satisfaction; pelvic organ prolapse; Pelvic Organ Prolapse - surgery; Polypropylene; Polypropylenes; Polyvinyls; Postoperative Complications - etiology; Retrospective Studies; sacrocolpopexy; Surgical Mesh - adverse effects; Treatment Outcome; vault prolapse; laparoscopy; sacrocolpopexy; vault prolapse; pelvic organ prolapse
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.24083

Aim To compare 2‐year outcomes of laparoscopic sacrocolpopexy (LSCP) either with polyvinylidene fluoride (PVDF) or hybrid polypropylene containing a resorbable polyglecaprone (PP+ PG) mesh. Materials and methods Retrospective audit on 105 consecutive patients undergoing LSCP a with PVDF‐mesh (DynaMesh, FEG Textiltechniken), matched by prolapse stage and cervicopexy or vault suspension to 105 controls undergoing LSCP with a hybrid PP + PG‐mesh (Ultrapro, Ethicon). Patients are part of an ongoing prospective study. The primary outcome measure was the Patient Global Impression of Change score (PGIC), the coprimary variable was failure rate at the vault (≤1 cm). Other outcomes were intraoperative and postoperative complications within 3 months categorized by the Clavien‐Dindo classification, reinterventions, graft‐related complications (GRCs) and functional outcomes. All assessments were performed by an independent assessor. Data are reported as median (interquartile range) number and percent as appropriate, the Mann‐Whitney U, χ2, or Fisher exact were used for comparison. Results Patient satisfaction in the PVDF group, as measured with the PGIC, was high (90.9% PGIC, ≥4) as well as was the anatomical success (97.3%) at a follow‐up of 26 months. These outcomes were comparable to those of PP + PG‐patients (84.8% PGIC, ≥4; 94.9% anatomical success). There were five patients (2.4%) with Dindo‐III or higher complications and three patients had GRCs (1.5%), without differences between mesh type. Level‐II posterior defects (Bp ≥ −1) were less likely in PVDF patients (34.1% vs 50% for PP + PG‐patients; P = .003). Women in the PVDF group also were less bothered by prolapse (7.5% vs 26.4%; P = .001), yet they complained more of constipation (15.0% vs 9.0%; P = .01). Conclusion There were no differences in patient satisfaction and anatomical outcomes after LSCP either with PVDF or PP + PG mesh.