A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse - 27/09/12
, Katerina Maxova, MD a, Oldrich Sottner, MD a, Kamil Svabik, MD, PhD b, Michal Mlcoch, MD f, Dusan Kolarik, MD a, Ivana Mala, PhD d, Ladislav Krofta, MD, PhD c, Michael J. Halaska, MD, PhD e
Reprints: Michael Halaska, MD, PhD, Department of Obstetrics and Gynecology, Charles University in Prague, First Medical Faculty and Faculty Hospital Bulovka, Budínova 2, 180 00 Prague 8, Czech RepublicRésumé |
Objective |
The objective of the study was to compare recurrence and complication rates for sacrospinous fixation (SSF) and prolene mesh techniques for the primary treatment of posthysterectomy vaginal vault prolapse.
Study Design |
Patients undergoing surgery for vault prolapse were included in a multicenter, randomized, controlled study comparing SSF or total mesh (Prolift; Gynecare/Ethicon, Somerville, NJ). The examination included pelvic organ prolapse quantification, urodynamics, ultrasound, and quality-of-life (QoL) questionnaires before and 3 and 12 months after surgery.
Results |
Of 168 randomized patients, 83 underwent SSF and 85 mesh repair. Prolapse recurrence after 12 months occurred in 39.4% of the SSF group and in 16.9% of the mesh group (P = .003). The mesh exposure rate was 20.8%. No difference in QoL improvement as well as of de novo stress urinary incontinence and overactive bladder onset was found.
Conclusion |
Mesh exposure occurrence was balanced against a lower prolapse recurrence rate in the patients undergoing mesh surgery compared with those undergoing SSF.
Le texte complet de cet article est disponible en PDF.Key words : pelvic organ prolapse quantification prolapse, Prolift, quality-of-life questionnaires, sacrospinous fixation
Plan
| This work was supported by grant NS 10453-3/2009 from the Ministry of Health Care of the Czech Republic, which did not participate in the study design, data collection, data analysis, manuscript preparation, or publication decisions. |
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| The authors report no conflict of interest. |
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| Cite this article as: Halaska M, Maxova K, Sottner O, et al. A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse. Am J Obstet Gynecol 2012;207:301.e1-7. |
Vol 207 - N° 4
P. 301.e1-301.e7 - octobre 2012 Retour au numéro
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