Efficacy and Safety Comparison of Robotic-Assisted Sacrocolpopexy Using Light-Weight and Heavy-Weight Polypropylene Mesh




Huang, Emily You

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AIMS: This study compares long-term surgical outcomes of light-weight polypropylene mesh (LWPPM) and heavy-weight polypropylene mesh (PPM) for robotic sacrocolpopexy (RSC). METHODS: Following IRB approval, a 2-surgeon POP database of women who underwent RSC at a single institution was reviewed. Minimum follow-up time was 6 months. Patients were stratified by mesh weight: Boston Scientific MarlexTM natural Trelex mesh or AtriumTM ProLite mesh (PPM) versus Caldera Medical Vertessa(r) Lite Y Polypropylene Mesh (LWPPM). Success was defined using a composite of absence of prolapse symptoms at the patient's most recent visit, no POP-Q point beyond the hymen, and no reoperation for POP. RESULTS: From 2007 to 2018, 110 patients met study criteria: 67 with LWPPM and 43 with PPM. The success rate of RSC using LWPPM at 12 months was 91.0% versus 90.7% for RSC with PPM (p =1). Over time, the mean follow-up length was 23.3 months in the LWPPM groups compared to 44.7 months in the PPM group (p <0.0002). The success rate at the last follow-up of RSC using LWPPM was significantly higher than that of RSC with PPM - 89.6% versus 72.1% (p =0.0221). Regarding complications, mesh extrusion rates varied (3.0% for LWPPM versus 11.6% for PPM at the last follow-up); however, this difference was not statistically significant (p=0.11) nor was the difference in management (p=0.15). CONCLUSIONS: RSC using LWPPM is a safe and effective procedure. Success rates using LWPPM are not inferior to those using PPM. Complication rates were low with either mesh.

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