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Outcomes following sacrocolpopexy in Pelvic Organ Prolapse (OsPOP) Mugdha K1, James A1, Daniel R1, Anna R1 1. Monash Health KEYWORDS: Pelvic Organ Prolapse, Surgery, Prolapse Symptoms Introduction Pelvic organ prolapse (POP) refers to downward descent of female pelvic organs into or through the vagina. POP is a common condition and prevalence varies on whether prolapse is defined using objective or subjective measures. Rates of POP are up to 50%, when defined using objective measures such as vaginal examination(1) and around 3% when defined as symptomatic bulge(2, 3). POP surgery prevalence ranges from 6 to 18% with over 300,000 surgeries performed annually in the US alone(1, 4). If a hysterectomy is performed for prolapse, recurrence rates of vault prolapse are estimated at 11.6%(5). Prolapse of the anterior vaginal wall or cystocele is the most common POP detected(6) and is strongly associated with apical prolapse(7). Current indications for sacrocolpopexy (SCP) include apical or multicompartment prolapse. Although SCP is an extensively studied and highly efficacious procedure there is significant heterogeneity in the surgical technique. This was illustrated in a systematic review by Moroni et al., which included 22 RCTs and assessed procedure standardization. In this review, most studies failed to describe the procedure steps in detail and there was heterogeneity in materials used for attaching mesh to vagina and sacrum, length of vaginal dissection from only dissecting apex to full vaginal length. Outcomes studied could be potentially influenced by technical choices intraoperatively(8). Other characteristics affecting outcome can be mesh weight, pore size and material used. Human and animal studies have shown that heavier mesh may be associated with more chronic inflammation and poorer remodelling of vagina as compared to light weight mesh(9). In 2018, Askew et al. compared anatomic failure rates between ultralight mesh (≤20 g/m2) with heavy mesh (≤35 g/m2). Ultralight weight mesh had twice the hazard of failure within 3 years compared to heavy weight mesh (p=0.03) with a lower mesh exposure rate (1.6% vs 6.0%, p= 0.01)(10). Aim of study To assess long-term anatomic and subjective outcomes following sacrocolpopexy based on the weight of mesh used.