PD32-05 COMPARISON OF HEAVY WEIGHT VERSUS LIGHT WEIGHT WIDE PORE POLYPROPYLENE MESH FOR ROBOTIC SACROCOLPOPEXY USING FOUR MESHES AND 351 CASES

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse (PD32)1 Sep 2021PD32-05 COMPARISON OF HEAVY WEIGHT VERSUS LIGHT WEIGHT WIDE PORE POLYPROPYLENE MESH FOR ROBOTIC SACROCOLPOPEXY USING FOUR MESHES AND 351 CASES Cassandra Schuster, Maximilian Carey, and Robert Carey Cassandra SchusterCassandra Schuster More articles by this author , Maximilian CareyMaximilian Carey More articles by this author , and Robert CareyRobert Carey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002033.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: All FDA approved wide pore polypropylene Y-mesh grafts available for robotic sacrocolpopexy have variance in the mesh weight, pore size, thickness, surface area ratio and suture pull out strengths. In this study we evaluated results observed for robotic sacrocolpopexy performed with four separate wide pore polypropylene Y meshes that differ markedly in their physical properties. METHODS: Data is collected from an IRB approved prospectively maintained retrospective database of robotic sacrocolpopexy cases performed at an 836 bed tertiary care hospital by a single surgeon. Using analysis matched for covariates of BMI, prolapse stage and previous attempts at repair, We evaluated whether the weight of the Y-mesh influenced the anatomic outcome and rate of de novo SUI at mean 46 month follow-up. RESULTS: Between 2011 and 2020, a total of 351 patients underwent robotic sacrocolpopexy for POP-Q Stage IV VVP. The cases were divided between 4 different mesh materials (n=50, 50, 100, and 151) in patients undergoing repair. The mesh material varied from the heaviest mesh weight (52 g/m2, 527 microns thick, and a suture pull out strength of 18.3 N) to the lightest weight mesh (25 g/m2, 200 microns thick, and suture pull out strength of 23.3 N). At mean 46 month follow-up, anatomic success for apical prolapse was 100% and there was no difference in the rates of Grade 2 or less anterior or posterior prolase in each group (4%). De novo SUI was found in 10% patients in the heaviest mesh group and in 8% of patients in the lighter mesh groups. All de novo SUI patients did not have a mid urethral sling, MUS, placed at the time of the procedure. There was one mesh erosion in the light weight mesh group in a salvage patient that underwent concomitant pre-existing mesh removal at the time of surgery. CONCLUSIONS: Although the two Y-meshes are markedly different in their weight, surface area, thickness and suture pullout strength, there was no observed significant difference in the anatomic success of repair, the rate of de novo stress urinary incontinence or mesh erosion. The rates of de novo SUI seen in this study, have led us to perform a MUS procedure at the time of sacrocolpopexy for all Grade IV prolapse patients. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e546-e546 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cassandra Schuster More articles by this author Maximilian Carey More articles by this author Robert Carey More articles by this author Expand All Advertisement Loading ...