Sacral Colpopexy Versus Transvaginal Mesh Colpopexy in Obese Patients |
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| Authors: | Colleen D. McDermott Jean Park Colin L. Terry Patrick J. Woodman Douglass S. Hale |
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| Affiliation: | 1. Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynaecology, St. Michael’s Hospital, University of Toronto, Toronto ON;2. Urogynecology and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente, Fontana CA;3. Department of Biostatistics, Methodist Hospital/Indiana University Health, Indianapolis IN;4. Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Methodist Hospital/Indiana University Health, Indianapolis IN;1. Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC;2. Department of Community Health Sciences, University of Manitoba, Winnipeg MB;3. Department of Obstetrics and Gynaecology, University of Calgary, Calgary AB;4. Department of medical Genetics, University of Calgary, Calgary AB;5. Department of Pediatrics, University of Calgary, Calgary AB;6. Department of Community Health Sciences, University of Calgary, Calgary AB;7. Department of Pathology and Laboratory Medicine, Saskatoon Health Region and College of Medicine, University of Saskatchewan, Saskatoon SK;1. Community Health Sciences, University of Manitoba, Winnipeg MB;2. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg MB;3. Department of Sociology, University of Manitoba, Winnipeg MB;1. Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON;2. Department of Medical Imaging, Mount Sinai Hospital, Toronto ON;3. Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ON |
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| Abstract: | ObjectivesObesity can predispose women to pelvic organ prolapse and can also affect the success of pelvic organ prolapse surgery. The purpose of this study was to compare the postoperative anatomical outcomes following sacral colpopexy (SC) and transvaginal mesh colpopexy in a group of obese women with pelvic organ prolapse.MethodsWe conducted a retrospective cohort study of obese women who underwent SC (n = 56) or transvaginal mesh colpopexy (n = 35). Follow-up ranged from 6 to 12 months. Preoperative, perioperative, and postoperative variables were compared using Student t, Mann?Whitney U, and Fisher exact tests, and by analysis of covariance.ResultsThe women in the SC group had significantly higher mean apical vaginal measurements (P < 0.05), and significantly fewer stage II recurrences than women in the transvaginal mesh colpopexy group. There were no significant differences between the groups for other postoperative outcomes, including mesh erosion, recurrent prolapse symptoms, dyspareunia, and surgical satisfaction (P > 0.05).ConclusionIn these 91 obese patients with pelvic organ prolapse, SC resulted in better anatomical outcomes than transvaginal mesh colpopexy. However, the two procedures had similar outcomes with regard to recurrent symptoms and surgical satisfaction. |
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