Factors associated with anterior compartment recurrence after laparoscopic sacropexy

The objective of this study was to identify factors associated with anatomical anterior compartment recurrence after laparoscopic mesh sacropexy. This single-center ambispective cohort study included 143 women who underwent laparoscopic mesh sacropexy for symptomatic pelvic organ prolapse. Women operated on before initiation of the study were identified retrospectively from institutional surgical records and subsequently recalled for postoperative anatomical assessment, whereas patients treated during the later study period were followed longitudinally. Only women with an anatomical postoperative assessment performed ≥12 months after surgery were included. Anatomical anterior compartment recurrence was evaluated using Pelvic Organ Prolapse Quantification (POP-Q) measurements. Associations with recurrence were examined using univariable and multivariable logistic regression. Recurrence occurred in 18 women (12.6%). Patients with recurrence were older and had greater preoperative descent of the upper anterior vaginal wall (POP-Q point Ba). In the primary multivariable model, age [odds ratio (OR) 1.09/year, 95% confidence interval (CI) 1.02-1.17; p=0.007], Ba (OR 1.29/cm, 95% CI 1.00-1.66; p=0.048), and anterior dissection length (OR 0.81/cm, 95% CI 0.67-0.98; p=0.034) were associated with recurrence. Body mass index was not independently associated. Adjustment for the year of surgery attenuated the dissection association (p=0.127). Greater preoperative Ba and increasing age were associated with anterior recurrence. Greater anterior dissection was associated with lower recurrence odds in the primary model, but this finding was sensitive to adjustments for the surgical year.