Understanding Sacrocolpopexy: Insights from Urology Specialists Drs. Lisa Parillo & Benjamin Wisner

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Lisa M. Parillo, MD, and Benjamin P. Wisner, MD, discuss sacrocolpopexy, focusing on surgical techniques, complications, and outcomes.

Dr. Perillo begins this 20-minute presentation by discussing her port placement strategy, emphasizing the advantages of an eight-millimeter assistant port over a traditional 12-millimeter one to minimize postoperative pain and hernia risk. She advocates for supracervical hysterectomy in sacrocolpopexy. Posterior repairs during sacrocolpopexy are debated, with some studies indicating higher anatomic recurrence rates without them, while others show no significant impact on defecation symptoms. Lastly, she discusses patient selection, advocating a BMI cutoff of 38 and cautioning smokers about higher mesh erosion rates.

Benjamin P. Wisner, MD, explores the complexities of sacrocolpopexy and the surgical decisions regarding total versus supracervical hysterectomy. Wisner debates the issue of sacrocolpopexy in patients without prior hysterectomy and considers the risk of trachelectomy in supracervical cases. Dr. Wisner shares his sacrocolpopexy technique, mesh selection and placement, tensioning techniques, and suturing strategies. He asserts that long-term follow-up is essential, with surgeon experience and technique refinement critical factors in optimizing outcomes.
Category
Urology
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