A Randomized Controlled Trial Comparing Fascia Lata and Synthetic Mesh for Sacral Colpopexy

Culligan, Patrick J.; Blackwell, Linda; Goldsmith, L. Jane; Graham, Caroline; Rogers, Aimee; Heit, Michael

doi:10.1097/01.aog.0000165824.62167.c1

Cited by 147 publications

(62 citation statements)

References 18 publications

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“…Pelvic organ prolapse is often associated with urinary incontinence; up to 91% of women who present for sacrocolpopexy require a concomitant anti-incontinence procedure (7,8). Sacrocolpopexy, an abdominal procedure in which the vagina is suspended to the sacrum with a nonabsorbable mesh, is the gold standard operation for pelvic organ prolapse (9).…”

Section: Introductionmentioning

confidence: 99%

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Trabuco

Klingele

Blandon

et al. 2016

Obstetrics &Amp; Gynecology

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Objective To compare efficacy and safety of retropubic Burch urethropexy and midurethral sling in women with SUI undergoing concomitant pelvic floor repair with sacrocolpopexy. Methods Women were randomly assigned to Burch retropubic urethropexy (n=56) or retropubic midurethral sling (n=57) through dynamic allocation balancing age, body mass index, history of prior incontinence surgery, intrinsic sphincter deficiency, preoperative incontinence diagnosis, and prolapse stage. Overall and stress-specific continence primary outcomes were ascertained with validated questionnaires and blinded cough stress test. Results Enrollment was June 1, 2009, through August 31, 2013. At 6 months, no difference was found in overall (29 midurethral sling [51%] vs 23 Burch [41%]; P=.30) (odds ratio [OR] [95% CI], 1.49 [0.71–3.13]) or stress-specific continence rates (42 midurethral sling [74%] vs 32 Burch [57%]; P=.06) (OR [95% CI], 2.10 [0.95–4.64]) between groups. However, the midurethral sling group reported greater satisfaction (78% vs 57%; P=.04) and were more likely to report successful surgery for SUI (71% vs 50%; P=.04), and to resolve preexisting urgency incontinence (72% vs 41%; P=.03). No difference was found in patient global impression of severity or symptom improvement, complication rates, or mesh exposures. Conclusion There was no difference in overall or stress-specific continence rates between midurethral sling and Burch urethropexy groups at 6 months. However, the midurethral sling group reported better patient-centered secondary outcomes.

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Section: Introductionmentioning

confidence: 99%

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Trabuco

Klingele

Blandon

et al. 2016

Obstetrics &Amp; Gynecology

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“…One trial compared abdominal sacral colpopexy using either an absorbable cadaveric fascia lata graft (Tutoplast) or a nonabsorbable monofilament polypropylene mesh (Trelex). In both groups there were no recurrences of vaginal prolapse [12]. …”

Section: Discussionmentioning

confidence: 99%

Neovaginal Prolapse in Male-to-Female Transsexuals: An 18-Year-Long Experience

Bucci

Mazzon

Liguori

et al. 2014

BioMed Research International

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Neovaginal prolapse is a rare and distressing complication after male-to-female sexual reassignment surgery. We retrospectively analysed the prevalence of partial and total neo-vaginal prolapses after sexual reassignment surgery in our institute. During the years, two different techniques have been adopted with the aim of fixing the neovaginal cylinder. In the first, two absorbable sutures are placed at the top of the penoscrotal cylinder and fixed to the Denonvilliers fascia. In the second, two additional sutures are added from the posterior/midpoint of the flap to the prerectal fascia. We enrolled 282 consecutive transsexual patients. 65 (23.04%) out of the 282 were treated with the first technique and the following 217 (76.96%) with the last technique. In the first technique, 1 case (1.53%) of total prolapse and 7 cases (10.76%) of partial prolapse were observed, while in the other 217 patients treated with the second technique only 9 cases of partial prolapse were observed (4.14%) and no cases of total prolapse. All prolapses occurred within 6 months from the procedure. In our experience, the use of 4 stitches and a more proximal positioning of the sutures to fix the penoscrotal apex with the Denonvilliers fascia guarantees a lower risk of prolapse.

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“…In an attempt to reduce mesh complications, some surgeons have considered the use of biological grafts. However, fascia lata had inferior anatomic outcomes, compared to polypropylene mesh [63]. …”

Section: Surgical Treatmentmentioning

confidence: 99%

Prevention and management of pelvic organ prolapse

Giarenis

Robinson

2014

F1000Prime Rep

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Pelvic organ prolapse is a highly prevalent condition in the female population, which impairs the health-related quality of life of affected individuals. Despite the lack of robust evidence, selective modification of obstetric events or other risk factors could play a central role in the prevention of prolapse. While the value of pelvic floor muscle training as a preventive treatment remains uncertain, it has an essential role in the conservative management of prolapse. Surgical trends are currently changing due to the controversial issues surrounding the use of mesh and the increasing demand for uterine preservation. The evolution of laparoscopic and robotic surgery has increased the use of these techniques in pelvic floor surgery.

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A Randomized Controlled Trial Comparing Fascia Lata and Synthetic Mesh for Sacral Colpopexy

Abstract: I.

Cited by 147 publications

References 18 publications

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Burch Retropubic Urethropexy Compared With Midurethral Sling With Concurrent Sacrocolpopexy

Neovaginal Prolapse in Male-to-Female Transsexuals: An 18-Year-Long Experience

Prevention and management of pelvic organ prolapse

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