Sacrocolpopexy for vault prolapse and rectocele: do concomitant Burch colposuspension and perineal mesh detachment affect the outcome?

Kaven Baessler, Stuart L Stanton
American Journal of Obstetrics and Gynecology 2005, 192 (4): 1067-72

OBJECTIVE: This study compares the effect of abdominal sacrocolpopexy with posterior Teflon mesh interposition with and without concomitant Burch colposuspension on the posterior compartment.

STUDY DESIGN: This retrospective review includes 49 consecutive women who underwent sacrocolpopexy for vault or uterine prolapse stage 2 or higher and rectocele; 25 of them had a concomitant Burch colposuspension for urodynamic stress incontinence. Postoperative bladder, bowel and sexual function and recurrent pelvic organ prolapse was assessed at > or =12 months.

RESULTS: There was no recurrent vault prolapse. Rectoceles (stage 2) recurred in 5 women (21%) without and in 8 women (36%) with Burch colposuspension ( P > .05). The mesh became detached by >2 cm from its perineal position in 30% of the cases, which was associated with excessive defecation straining ( P = .04). Rectocele stages significantly correlated with mesh detachment ( P > .001) but not with obstructed defecation ( P > .05).

CONCLUSION: Sacrocolpopexy was effective if the mesh did not become detached from its perineal position. Concomitant Burch colposuspension did not seem to affect the posterior compartment adversely in this small case series.

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