MESH EROSION AFTER ABDOMINAL SACROCOLPOPEXY

Objective: To report our experience with erosion of permanent suture o r mesh material after abdominal sacrocolpopexy. Methods: A retrospecti ve chart review was performed to identify patients who underwent sacro colpopexy by the same surgeon over 8 years. Demographic data, operativ e notes, hospital records, and office charts were reviewed after sacro colpopexy. Patients with erosion of either suture or mesh were treated initially with conservative therapy followed by surgical intervention as required. Results: Fifty-seven patients underwent sacrocolpopexy u sing synthetic mesh during the study period. The mean (range) postoper ative follow-up was 19.9 (1.3-50) months. Seven patients (12%) had ero sions after abdominal sacrocolpopexy with two suture erosions and five mesh erosions. Patients with suture erosion were asymptomatic compare d with patients with mesh erosion, who presented with vaginal bleeding or discharge. The mean (+/- standard deviation) time to erosion was 1 4.0 +/- 7.7 (range 4-24) months. Both patients with suture erosion wer e treated conservatively with estrogen cream. All five patients with m esh erosion required transvaginal removal of the mesh. Conclusion: Mes h erosion can follow abdominal sacrocolpopexy over a long time, and us ually presents as vaginal bleeding or discharge. Although patients wit h suture erosion can be managed successfully with conservative treatme nt, patients with mesh erosion require surgical intervention. Transvag inal removal of the mesh with vaginal advancement appears to be an eff ective treatment in patients failing conservative management. (Obstet Gynecol 1998;92: 999-1004. (C) 1998 by The American College of Obstetr icians and Gynecologists.).