A comparative study of laparoscopic sacrocolpopexy and total vaginal mesh procedure using lightweight XXXX meshes for prolapse repair.

@entity1 @entity7502 @entity3577
OBJECTIVE: Use of vaginal meshes for treatment of @entity3577 ( @entity3577 ) remains controversial. A trend toward abdominal approaches and the development of new meshes has been noted. We compared the 1-year results of two different approaches using new lightweight meshes. MATERIALS AND METHODS: Sixty-nine (95.8%) of 72 @entity1 with @entity3577 Stage  >=   2, who underwent laparoscopic sacrocolpopexy (LSC) (n  =  39) or a total vaginal mesh (TVM) procedure (n  =  30) using lightweight @entity7502 meshes, were studied. Baseline and follow-up assessments included a pelvic examination and a composite condition-specific questionnaire. A detailed comparison of 1-year outcomes was made. Data were analyzed using appropriate statistical methods. RESULTS: Compared to the TVM group, the LSC group was characterized by a younger age (53.7 years vs. 64.1 years, p  <  0.001) and a longer operating time (264 minutes vs. 177.6 minutes, p  <  0.001). Objective anatomic success ( @entity3577 Stage   <=  1) rates were similar between groups after statistical adjustment, i.e., 84.6% (33/39) and 86.7% (26/30) after LSC and TVM (p  =  0.94), respectively. However, the dominant recurrence sites were different with anterior (n  =  6) most frequent after LSC and apical (n  =  4) most frequent after TVM. Reoperations were needed for the four (13.3%) apical recurrences in the TVM group. No serious complications were noted. We found "cystocele as the dominant prolapse" (p  =  0.016; odds ratio  =  6.94) and "suspension of prolapsed ( @entity3577 Stage  >=   2) uterus" (p  =  0.025; odds ratio  =  7.00) significantly affected recurrence after LSC and TVM, respectively. CONCLUSION: @entity3577 repair by LSC or TVM using the new lightweight @entity7502 meshes seems to be safe and has comparable outcomes, but limitations may vary.
