Cargando…
The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial
INTRODUCTION AND HYPOTHESIS: The aim of the study was to compare the efficacy and safety of transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy for treatment of anterior vaginal wall prolapse. METHODS: This is a randomized controlled trial in which women with advanc...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer London
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824218/ https://www.ncbi.nlm.nih.gov/pubmed/23632800 http://dx.doi.org/10.1007/s00192-013-2092-0 |
_version_ | 1782290677202157568 |
---|---|
author | Delroy, Carlos A. de A. Castro, Rodrigo Dias, Márcia M. Feldner, Paulo C. Bortolini, Maria Augusta T. Girão, Manoel J. B. C. Sartori, Marair G. F. |
author_facet | Delroy, Carlos A. de A. Castro, Rodrigo Dias, Márcia M. Feldner, Paulo C. Bortolini, Maria Augusta T. Girão, Manoel J. B. C. Sartori, Marair G. F. |
author_sort | Delroy, Carlos A. |
collection | PubMed |
description | INTRODUCTION AND HYPOTHESIS: The aim of the study was to compare the efficacy and safety of transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy for treatment of anterior vaginal wall prolapse. METHODS: This is a randomized controlled trial in which women with advanced anterior vaginal wall prolapse, at least stage II with Ba ≥ +1 cm according to the Pelvic Organ Prolapse Quantification (POP-Q) classification, were randomly assigned to have either anterior colporrhaphy (n = 39) or repair using trocar-guided transvaginal mesh (n = 40). The primary outcome was objective cure rate of the anterior compartment (point Ba) assessed at the 12-month follow-up visit, with stages 0 and I defined as anatomical success. Secondary outcomes included quantification of other vaginal compartments (POP-Q points), comparison of quality of life by the prolapse quality of life (P-QOL) questionnaire, and complication rate between the groups after 1 year. Study power was fixed as 80 % with 5 % cutoff point (p < 0.05) for statistical significance. RESULTS: The groups were similar regarding demographic and clinical preoperative parameters. Anatomical success rates for colporrhaphy and repair with mesh placement groups were 56.4 vs 82.5 % (95 % confidence interval 0.068–0.54), respectively, and the difference between the groups was statistically significant (p = 0.018). Similar total complication rates were observed in both groups, with tape exposure observed in 5 % of the patients. There was a significant improvement in all P-QOL domains as a result of both procedures (p < 0.001), but they were not distinct between groups (p > 0.05). CONCLUSIONS: Trocar-guided transvaginal synthetic mesh for advanced anterior POP repair is associated with a higher anatomical success rate for the anterior compartment compared with traditional colporrhaphy. Quality of life equally improved after both techniques. However, the trial failed to detect differences in P-QOL scores and complication rates between the groups. |
format | Online Article Text |
id | pubmed-3824218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Springer London |
record_format | MEDLINE/PubMed |
spelling | pubmed-38242182013-11-21 The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial Delroy, Carlos A. de A. Castro, Rodrigo Dias, Márcia M. Feldner, Paulo C. Bortolini, Maria Augusta T. Girão, Manoel J. B. C. Sartori, Marair G. F. Int Urogynecol J Original Article INTRODUCTION AND HYPOTHESIS: The aim of the study was to compare the efficacy and safety of transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy for treatment of anterior vaginal wall prolapse. METHODS: This is a randomized controlled trial in which women with advanced anterior vaginal wall prolapse, at least stage II with Ba ≥ +1 cm according to the Pelvic Organ Prolapse Quantification (POP-Q) classification, were randomly assigned to have either anterior colporrhaphy (n = 39) or repair using trocar-guided transvaginal mesh (n = 40). The primary outcome was objective cure rate of the anterior compartment (point Ba) assessed at the 12-month follow-up visit, with stages 0 and I defined as anatomical success. Secondary outcomes included quantification of other vaginal compartments (POP-Q points), comparison of quality of life by the prolapse quality of life (P-QOL) questionnaire, and complication rate between the groups after 1 year. Study power was fixed as 80 % with 5 % cutoff point (p < 0.05) for statistical significance. RESULTS: The groups were similar regarding demographic and clinical preoperative parameters. Anatomical success rates for colporrhaphy and repair with mesh placement groups were 56.4 vs 82.5 % (95 % confidence interval 0.068–0.54), respectively, and the difference between the groups was statistically significant (p = 0.018). Similar total complication rates were observed in both groups, with tape exposure observed in 5 % of the patients. There was a significant improvement in all P-QOL domains as a result of both procedures (p < 0.001), but they were not distinct between groups (p > 0.05). CONCLUSIONS: Trocar-guided transvaginal synthetic mesh for advanced anterior POP repair is associated with a higher anatomical success rate for the anterior compartment compared with traditional colporrhaphy. Quality of life equally improved after both techniques. However, the trial failed to detect differences in P-QOL scores and complication rates between the groups. Springer London 2013-04-30 2013 /pmc/articles/PMC3824218/ /pubmed/23632800 http://dx.doi.org/10.1007/s00192-013-2092-0 Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Article Delroy, Carlos A. de A. Castro, Rodrigo Dias, Márcia M. Feldner, Paulo C. Bortolini, Maria Augusta T. Girão, Manoel J. B. C. Sartori, Marair G. F. The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial |
title | The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial |
title_full | The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial |
title_fullStr | The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial |
title_full_unstemmed | The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial |
title_short | The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial |
title_sort | use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824218/ https://www.ncbi.nlm.nih.gov/pubmed/23632800 http://dx.doi.org/10.1007/s00192-013-2092-0 |
work_keys_str_mv | AT delroycarlosa theuseoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT deacastrorodrigo theuseoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT diasmarciam theuseoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT feldnerpauloc theuseoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT bortolinimariaaugustat theuseoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT giraomanoeljbc theuseoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT sartorimarairgf theuseoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT delroycarlosa useoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT deacastrorodrigo useoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT diasmarciam useoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT feldnerpauloc useoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT bortolinimariaaugustat useoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT giraomanoeljbc useoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial AT sartorimarairgf useoftransvaginalsyntheticmeshforanteriorvaginalwallprolapserepairarandomizedcontrolledtrial |