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Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh

Aim of the study: The aim of this study was to evaluate the anatomical results after an anterior sacrospinous ligament fixation (ASSLF) with native tissue repair (anterior colporraphy and apical suspension with prolene) compared to mesh repair for the correction of anterior prolapse at 12 months aft...

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Autores principales: Cassagne, Charlotte, Perriard, Francoise, Cornille, Arnaud, Salerno, Jennifer, Panel, Laure
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056778/
https://www.ncbi.nlm.nih.gov/pubmed/36983214
http://dx.doi.org/10.3390/jcm12062212
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author Cassagne, Charlotte
Perriard, Francoise
Cornille, Arnaud
Salerno, Jennifer
Panel, Laure
author_facet Cassagne, Charlotte
Perriard, Francoise
Cornille, Arnaud
Salerno, Jennifer
Panel, Laure
author_sort Cassagne, Charlotte
collection PubMed
description Aim of the study: The aim of this study was to evaluate the anatomical results after an anterior sacrospinous ligament fixation (ASSLF) with native tissue repair (anterior colporraphy and apical suspension with prolene) compared to mesh repair for the correction of anterior prolapse at 12 months after surgery. Materials and methods: A monocentric prospective study comparing two similar cohorts who underwent ASSLF was conducted. The primary endpoint was the gain in the position of the Ba point relative to its position before surgery and twelve months after surgery. The secondary endpoints consisted of objective results, which were assessed using validated questionnaires. Results: Fifty-three women were included in the native tissue repair group between June 2019 and March 2020. They were compared to 53 women operated on with anterior and apical mesh. There was no difference with respect to the Ba point after 1 year between the two groups (−2 [−3; 1.5]; −2 [−3; 1], p = 0.9789). The apex was significantly better corrected in the native tissue repair group (−7 vs. −6, p = 0.0007). There was also a better correction on the rectocele in the native tissue repair group (−3 vs. −2, p = 0.0178). The rate of Stage 2 anterior vaginal prolapse at one year was approximately 30% in both groups (no statistical difference). Conclusions: ASSFL without mesh does not increase the risk of cystocele recurrence at 1 year after surgery. A future prospective comparison of this native tissue repair technique with mesh suspension is necessary to explore these preliminary findings.
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spelling pubmed-100567782023-03-30 Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh Cassagne, Charlotte Perriard, Francoise Cornille, Arnaud Salerno, Jennifer Panel, Laure J Clin Med Article Aim of the study: The aim of this study was to evaluate the anatomical results after an anterior sacrospinous ligament fixation (ASSLF) with native tissue repair (anterior colporraphy and apical suspension with prolene) compared to mesh repair for the correction of anterior prolapse at 12 months after surgery. Materials and methods: A monocentric prospective study comparing two similar cohorts who underwent ASSLF was conducted. The primary endpoint was the gain in the position of the Ba point relative to its position before surgery and twelve months after surgery. The secondary endpoints consisted of objective results, which were assessed using validated questionnaires. Results: Fifty-three women were included in the native tissue repair group between June 2019 and March 2020. They were compared to 53 women operated on with anterior and apical mesh. There was no difference with respect to the Ba point after 1 year between the two groups (−2 [−3; 1.5]; −2 [−3; 1], p = 0.9789). The apex was significantly better corrected in the native tissue repair group (−7 vs. −6, p = 0.0007). There was also a better correction on the rectocele in the native tissue repair group (−3 vs. −2, p = 0.0178). The rate of Stage 2 anterior vaginal prolapse at one year was approximately 30% in both groups (no statistical difference). Conclusions: ASSFL without mesh does not increase the risk of cystocele recurrence at 1 year after surgery. A future prospective comparison of this native tissue repair technique with mesh suspension is necessary to explore these preliminary findings. MDPI 2023-03-13 /pmc/articles/PMC10056778/ /pubmed/36983214 http://dx.doi.org/10.3390/jcm12062212 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cassagne, Charlotte
Perriard, Francoise
Cornille, Arnaud
Salerno, Jennifer
Panel, Laure
Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh
title Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh
title_full Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh
title_fullStr Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh
title_full_unstemmed Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh
title_short Anterior and Apical Prolapse: Comparison of Vaginal Mesh Surgery to Vaginal Surgery with No Mesh
title_sort anterior and apical prolapse: comparison of vaginal mesh surgery to vaginal surgery with no mesh
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10056778/
https://www.ncbi.nlm.nih.gov/pubmed/36983214
http://dx.doi.org/10.3390/jcm12062212
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