Post-operative outcomes associated with anterior mesh location after laparoscopic sacrocolpopexy

To investigate the relationship between the anatomical position of the anterior arm of the mesh, measured by ultrasound through the bladder neck–mesh distance technique and the surgical outcomes after laparoscopic sacrocolpopexy (SCP) for apical prolapse.

It was a retrospective analysis of prospectively collected data in a tertiary care hospital. Between January 2019 and September 2019, 63 women who underwent laparoscopic SCP due to apical prolapse were included. Bladder neck–mesh distance was measured immediately after surgery. The pelvic floor was evaluated using the Pelvic Organ Prolapse Quantification (POP-Q) System before, 1 month, and 2.7 years (mid-term) after the surgery. Post-operative stress urinary incontinence (SUI) and Patient Global Impression of Improvement (PGI-I) scores were also assessed. The correlation between bladder neck–mesh distance and the post-operative outcomes was investigated using the Spearman rank correlation coefficient.

At mid-term follow-up visit, bladder neck–mesh distance was inversely correlated with the correction of apical prolapse and post-operative SUI. No correlation was detected with the anterior compartment prolapse correction. PGI-I scores were high in all patients at mid-term follow-up, irrespective of bladder neck–mesh distance values.

The shorter the bladder neck–mesh distance, the better the outcome for apical compartment repair. Bladder neck–mesh distance had no correlation with the anterior anatomical correction. Shorter bladder neck–mesh distance values were positively correlated to better PGI-I scores and a higher risk of SUI.