{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T21:34:43Z","timestamp":1794346483573,"version":"4.9.0"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T00:00:00Z","timestamp":1486425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Laparoscopic sacrocolpopexy is becoming an increasingly popular surgical approach for repair of apical vaginal prolapse. The aim of this study was to document the postoperative anterior mesh position after laparoscopic sacrocolpopexy and to investigate the relationship between mesh location and anterior compartment support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an external audit of patients who underwent laparoscopic sacrocolpopexy for apical prolapse \u2265 Stage 2 or advanced prolapse \u2265 Stage 3, between January 2005 and June 2012. All patients were assessed with a standardized interview, clinical assessment using the International Continence Society Pelvic Organ Prolapse quantification and four\u2010dimensional transperineal ultrasound to evaluate pelvic organ support and mesh location. Mesh position was assessed with respect to the symphysis pubis whilst distal mesh mobility was assessed using the formula \u221a[(<jats:italic>X<\/jats:italic><jats:sub>Valsalva<\/jats:sub> \u2013 <jats:italic>X<\/jats:italic><jats:sub>rest<\/jats:sub>)<jats:sup>2<\/jats:sup> + (<jats:italic>Y<\/jats:italic><jats:sub>Valsalva<\/jats:sub> \u2013 <jats:italic>Y<\/jats:italic><jats:sub>rest<\/jats:sub>)<jats:sup>2<\/jats:sup>], where <jats:italic>X<\/jats:italic> is the horizontal distance and <jats:italic>Y<\/jats:italic> is the vertical distance between the mesh and the inferior symphyseal margin, measured at rest and on Valsalva.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010seven women were assessed at a mean follow\u2010up of 3.01 (range, 0.13\u20136.87) years after laparoscopic sacrocolpopexy, 88% (85\/97) of whom considered themselves to be cured or improved, and none had required reoperation. On clinical examination, prolapse recurrence in the apical compartment was not diagnosed in any patient; however, 60 (62%) had recurrence in the anterior compartment and 43 (44%) in the posterior compartment. On ultrasound examination, mesh was visualized in the anterior compartment in 60 patients. Both mesh position and mobility on Valsalva were significantly associated with recurrent cystocele on clinical and on ultrasound assessment (all <jats:italic>P<\/jats:italic> &lt; 0.01). For every mm that the mesh was located further from the bladder neck on Valsalva, the likelihood of cystocele recurrence increased by 6\u20137%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>At an average follow\u2010up of 3 years, laparoscopic sacrocolpopexy was highly effective for apical support; however, cystocele recurrence was common despite an emphasis on anterior mesh extension. Prolapse recurrence seemed to be related to mesh position and mobility, suggesting that the lower the mesh is from the bladder neck, the lower the likelihood of anterior compartment prolapse recurrence. Copyright \u00a9 2016 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15882","type":"journal-article","created":{"date-parts":[[2016,2,15]],"date-time":"2016-02-15T09:22:52Z","timestamp":1455528172000},"page":"404-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Laparoscopic sacrocolpopexy: how low does the mesh go?"],"prefix":"10.1002","volume":"49","author":[{"given":"V.","family":"Wong","sequence":"first","affiliation":[{"name":"Nepean Clinical School University of Sydney  Penrith NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Guzman Rojas","sequence":"additional","affiliation":[{"name":"Nepean Clinical School University of Sydney  Penrith NSW Australia"},{"name":"Clinica Alemana de Santiago  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. L.","family":"Shek","sequence":"additional","affiliation":[{"name":"Nepean Clinical School University of Sydney  Penrith NSW Australia"},{"name":"Liverpool Hospital, University of Western Sydney  Penrith NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Chou","sequence":"additional","affiliation":[{"name":"St George's Hospital, University of New South Wales  Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. H.","family":"Moore","sequence":"additional","affiliation":[{"name":"St George's Hospital, University of New South Wales  Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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