Abstract Introduction and Hypothesis Although the role of uterine preservation during open sacrocolpopexy was well-explored, data regarding laparoscopic sacrocolpopexy (LSC) are controversial. This study was aimed at comparing the risk of mesh exposure between LSC with total hysterectomy and the uterine-preserving approach. Methods This retrospective cohort study included 198 patients who underwent LSC for pelvic organ prolapse. Based on surgical approach, patients were divided into two groups: those with concomitant total hysterectomy ( n = 169) and those who underwent uterus-preserving LSC ( n = 29). The primary outcome was mesh exposure. A logistic regression model was employed to calculate odd ratios (OR) and 95% confidence interval (CI) while adjusting potential confounding factors. Secondary outcomes included the composite success, anatomical outcomes, and self-reported symptom improvement. Results The median follow-up time of the whole cohort was 32 months. The incidence of mesh exposure was higher in the hysterectomy group compared with the uterine preservation group (27 out of 169, 16.0% vs 1 out of 29, 3.4%, p = 0.13). After controlling confounding factors, concomitant hysterectomy was associated with a nearly tenfold increased risk of mesh exposure (adjusted OR, 9.9; 95% CI, 1.5 to 199.0). There was no statistically significant difference in the composite success endpoint between the two groups (107 out of 131, 81.7% vs 21 out of 25, 84.0%, p = 0.99). Conclusions Concomitant hysterectomy during LSC was associated with increased risk of mesh exposure, and the composite success rates of the two groups were similar.
Yin et al. (Tue,) studied this question.