Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial - 19/08/11
, Benjamin Feiner, MD a, Eva M. DeCuyper, MD a, Cathy J. Nichlos, RN a, Kacey V. Hickey, RN a, Peter O'Rourke, PhD b
Reprints: Christopher Maher, MD, 86/30 Chasely St., Auchenflower 4066 Brisbane, AustraliaRésumé |
Objective |
To compare the laparoscopic sacral colpopexy and total vaginal mesh for vaginal vault prolapse.
Study Design |
Women with symptomatic stage ≥2 vault prolapse were randomly allocated the laparoscopic sacral colpopexy (53) or total vaginal mesh (55). Primary outcome measures were objective success rates at pelvic organ prolapse quantification sites individually and collectively. Secondary outcome measures included perioperative outcomes, patient satisfaction, quality of life outcomes, complications, and reoperations.
Results |
The laparoscopic sacral colpopexy group had a longer operating time, reduced inpatient days, and quicker return to activities of daily living as compared with the total vaginal mesh group. At the 2-year review, the total objective success rate at all vaginal sites was 41 of 53 (77%) for laparoscopic sacral colpopexy as compared with 23 of 55 (43%) in total vaginal mesh (P < .001). Reoperation rate was significantly higher after the vaginal mesh surgery 12 of 55 (22%) as compared with laparoscopic sacral colpopexy 3 of 53 (5%) (P = .006).
Conclusion |
At 2 years, the laparoscopic sacral colpopexy had a higher satisfaction rate and objective success rate than the total vaginal mesh with lower perioperative morbidity and reoperation rate.
Le texte complet de cet article est disponible en PDF.Key words : laparoscopic sacral colpopexy, vaginal mesh repair, vaginal vault prolapse
Plan
| The study was supported by competitive research grants from the Australian Gynaecological Endoscopy Society, 2007 and 2008, Sydney, Australia. |
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| Cite this article as: Maher CF, Feiner B, DeCuyper EM, et al. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol 2011;204:360.e1-7. |
Vol 204 - N° 4
P. 360.e1-360.e7 - avril 2011 Retour au numéro
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