Mesh erosion in abdominal sacral colpopexy with and without concomitant hysterectomy

Objective The purpose of this study was to examine risk factors for mesh erosion, including concomitant hysterectomy, in abdominal sacral colpopexies. Study design We conducted a retrospective cohort study of 313 women who underwent an abdominal sacral colpopexy. Data regarding patient demographics, operative techniques, length of follow-up, postoperative complications, and mesh erosion were collected. Results Of 313 subjects, 101 (32.3%) had concomitant hysterectomies and 212 (67.7%) had had previous hysterectomies. The overall rate of mesh erosion was 5.4%. In bivariate analysis, concomitant hysterectomy was not associated with erosion (6.9% vs 4.7% previous hysterectomy, P = .42); however, estrogen therapy was an effect modifier. In women on estrogen, hysterectomy (OR 4.9, CI 1.2-19.7) and anterior imbrication (OR 5.6, CI 1.1-28.6) were associated with mesh erosion. No risk factors were identified in women not on estrogen. Conclusion In women on estrogen therapy, hysterectomy was associated with mesh erosion in abdominal sacral colpopexy.