Anterior Colporrhaphy With and Without Dermal Allograft: A Randomized Control Trial With Long-Term Follow-Up

Iyer, Shilpa; Seitz, Miriam; Tran, Alexis; Reis, Renata Scalabrin; Botros, Carolyn; Lozo, Svjetlana; Botros, Sylvia M.; Sand, Peter K.; Tomezsko, Janet; Wang, Chi; Gafni-Kane, Adam

doi:10.1097/spv.0000000000000524

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…The estimated number of required participants is based on the primary outcome. We estimate that the rate of success defined by combined objective and subjective measures of the anterior colporraphy is about 45% at 1 year, with anatomical success defined with Aa and Ba point of 0 [ 6 , 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…Prospective studies have shown anatomical success rates of anterior colporraphy ranging from 42% [ 11 ] to 69% [ 12 ]. Retrospective studies have shown functional success rates between 72.7% [ 5 ] and 78% [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, their definition of anatomic success was restrictive (POP-Q< 2), while “no prolapse among the hymen” (corresponding to Aa and Ba points < 0) may be a better definition of anatomical success. Iyer showed lower failure rates of anterior colporraphy with about 10% difference between anatomical failure defined by Aa point or Ba point greater than or equal to − 1 at 1 year post-operative and anterior failure as Aa or Ba of 0 [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Protocol for a randomized controlled trial to assess two procedures of vaginal native tissue repair for pelvic organ prolapse at the time of the questioning on vaginal prosthesis: the TAPP trial

Lacorre

Vidal

Campagne-Loiseau

et al. 2020

Trials

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Background: Native tissue cystocele repair has been the cornerstone of prolapse surgery, especially since the learned societies warned clinicians and patients about serious mesh-related complications. Surgical techniques mainly consist in anterior colporraphy and vaginal patch plastron. However, success rates of native tissue cystocele repair are heterogeneous, depending on the design of studies and definition of outcomes. To date, high-quality data comparing vaginal native tissue procedures are still lacking. Methods: Herein we aimed to describe the design of the first randomized controlled trial (TAPP) comparing anterior colporraphy (plication of the muscularis and adventitial layers of the vaginal wall) and vaginal patch plastron (bladder support anchored on the tendinous arch of the pelvic fascia by lateral sutures) techniques. Our aim is to assess the effectiveness of vaginal native tissue repair at 1 year for cystocele with a combined definition of success-anatomic and functional. The primary endpoint will be the success rate 1 year after surgery with a composite of objective and subjective measures (Aa and Ba points < 0 from POP-Q (Pelvic Organ Prolapse Quantification System) and a negative answer to question 3 of Pelvic Floor Distress Inventory and no need for additional treatment).

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Protocol for a randomized controlled trial to assess two procedures of vaginal native tissue repair for pelvic organ prolapse at the time of the questioning on vaginal prosthesis: the TAPP trial

Lacorre

Vidal

Campagne-Loiseau

et al. 2020

Trials

View full text Add to dashboard Cite

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“…Kelly et al proposed an anterior colporrhaphy with tissue plication just below the bladder and urethra [6] . The entire assembly was then fixed in the periurethral plane and reattached to the midline.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal and transobturator autologous vaginal tape cystocele treatment: About an uncommon case

Slaoui

Slaoui²,

Himmi

et al. 2022

International Journal of Surgery Case Reports

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“…The strength of our study is the prospective randomised design, Similar published studies on this topic had also presented results with small sample sizes and multiple surgeons. 33,34 Finally, the study is based on the presence or absence of a thin layer of loose connective tissue in the anterior vaginal wall trimming. The nature of this connective tissue, and its role in the pathogenesis and repair of vaginal wall prolapse, is controversial.…”

Section: Strength and Limitationsmentioning

confidence: 99%

The role of hydrodissection in native tissue repair of anterior vaginal wall defects

Schwarzman

Samueli

Shaco-Levy

et al. 2021

Aust NZ J Obst Gynaeco

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A variety of surgical techniques are available for vaginal prolapse repair, indicating a lack of consensus. A debate regarding the utility of hydrodissection for splitting the surgical plane of the vaginal wall exists. The aim of this study is to evaluate the impact of hydrodissection in anterior colporrhaphy (AC). Materials:Patients undergoing primary AC were randomly assigned to an approach with (study group) versus without (control group) hydrodissection. Five surgeons performed both techniques, and the trimmed vaginal tissue was retrieved for histological analysis. Two pathologists, blinded to the surgical approach, evaluated the presence of a loose connective tissue at the surgical dissection plane (controversially deemed 'fascia', as explained in this article). In addition, we compared the operative time, pain score and haemoglobin levels. After statistical analysis, data were presented using percentile, and statistical significance was tested using the χ 2 and Fisher's exact tests.Results: Forty-six patients underwent primary elective AC, with 23 patients in each, the study and control groups. The groups were comparable regarding age (study group 60.33 ± 11.95 years and control group 59.86 ± 12.04, P = 0.90), menopausal status (study group 17 (73.9%) and control group 15 (68.2%), P = 0.67) and other characteristics. We found no difference in sample characteristics between the two groups. Connective tissue was found in only 13.6% (n = 3) of patients after hydrodissection and in 27.3% (n = 6) of patients without hydrodissection (P = 0.46). The hydrodissection group had significantly less bleeding than the control group (ΔHB 0.66 ± 0.66 vs 1.21 ± 0.84, P = 0.05). Conclusions:After hydrodissection, less bleeding was noted without compromise the surgical planes.

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Anterior Colporrhaphy With and Without Dermal Allograft: A Randomized Control Trial With Long-Term Follow-Up

Abstract: We cannot conclude whether there is a difference in anterior recurrence for anterior colporrhaphy with and without dermal allograft and do not recommend changes in clinical practice based on these results.

Cited by 8 publications

References 16 publications

Protocol for a randomized controlled trial to assess two procedures of vaginal native tissue repair for pelvic organ prolapse at the time of the questioning on vaginal prosthesis: the TAPP trial

Protocol for a randomized controlled trial to assess two procedures of vaginal native tissue repair for pelvic organ prolapse at the time of the questioning on vaginal prosthesis: the TAPP trial

Transvaginal and transobturator autologous vaginal tape cystocele treatment: About an uncommon case

The role of hydrodissection in native tissue repair of anterior vaginal wall defects

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