Glue mesh fixation in laparoscopic sacrocolpopexy: results at 3years' follow-up.

Abstract

We assessed 3-year anatomic and functional results using synthetic glue to fix mesh in laparoscopic sacrocolpopexy. Prospective multicenter cohort study in three academic urogynecology departments. Seventy consecutive patients with stage ≥ 3 POP-Q (Pelvic Organ Prolapse Quantification) anterior and/or apical prolapse underwent laparoscopic sacrocolpopexy using synthetic surgical glue to fix anterior and posterior meshes to the vagina. Patients were followed up at 1, 2 and 3years. Primary outcome was anterior and apical anatomic success (POP-Q stage ≤ 1) at 3years. Secondary outcomes comprised functional results (international quality of life and sexuality scales), mesh-related morbidity and urinary incontinence at 3years. Mean age was 56.7 ± 1.2years. Mean follow-up was 43months. Anterior compartment anatomic success rate was 87% at 2years (Ba, -2.4cm; p < 0.0001) and 86.5% at 3years (Ba, -2.3cm; p < 0.0001); apical success was 96.3% at 2years (C, -6.8cm; p < 0.0001) and 97.3% at 3years (C, -6.5cm; p < 0.0001). All quality-of-life scores improved significantly and lastingly at 3years: PFDI-20, PFIQ-7 and PISQ-12, respectively, p < 0.0001, p < 0.0001 and p = 0.01. There was one case of vaginal mesh exposure at 3years (2.8%) and five of mesh shrinkage at 1year (7.8%), none at 2years and two at 3years (5.4%). Urinary incontinence rate was 29.7% at 1year, 14.8% at 2years and 11.1% at 3years. Vaginal mesh adhesive in laparoscopic sacrocolpopexy remained effective at 3years, with excellent tolerance and no specific complications. Anatomic and functional results were good and enduring in terms of both anterior and apical correction.