Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar‐guided transobturator anterior mesh

Vollebregt, Astrid; Vaart, C. H. van der

doi:10.1111/j.1471-0528.2012.03372.x

Cited by 9 publications

(17 citation statements)

References 6 publications

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“…In 2011 the US Food and Drug Administration issued a safety communication to alert clinicians to mesh complications. While mesh implants are not innocuous and complications such as chronic pain and vaginal mesh exposure do occur, mesh implants have been shown to be effective in reducing prolapse recurrence, especially in patients with levator avulsion. According to Rodrigo et al the risk of recurrence in individuals has been shown to vary from 10 to 90%, depending on the state of the levator ani muscle and levator hiatal area.…”

Section: Discussionmentioning

confidence: 99%

“…Cystocele is a challenging condition in pelvic reconstructive surgery, with a reported failure rate after anterior colporrhaphy of up to 40–63%. To improve the surgical outcome of cystocele repair, there is a trend towards the use of synthetic implants to augment it.…”

Section: Introductionmentioning

confidence: 99%

“…To improve the surgical outcome of cystocele repair, there is a trend towards the use of synthetic implants to augment it. This has been shown to be effective in reducing recurrence, even in women with levator avulsion, which appears to be a strong risk factor for prolapse recurrence. However, recurrence is still common after vaginal mesh interposition.…”

Section: Introductionmentioning

confidence: 99%

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Anterior compartment mesh: a descriptive study of mesh anchoring failure

Shek

Wong

Lee

et al. 2013

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anterior compartment mesh: a descriptive study of mesh anchoring failure

Shek

Wong

Lee

et al. 2013

Ultrasound in Obstet & Gyne

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“…Pelvic organ prolapse (POP) is frequently observed in women, but surgical correction by colporrhaphy is associated with a high recurrence rate, especially in the anterior compartment . Consequently, there has been a search for methods other than the plication of fascial remnants or the approximation of fascia torn off from the arcus tendineus.…”

Section: Introductionmentioning

confidence: 99%

A 3–year follow‐up after anterior colporrhaphy compared with collagen‐coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial

Rudnicki

Laurikainen

Pogosean

et al. 2015

BJOG

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Objective To compare the 1-year (previously published) and 3-year objective and subjective cure rates, and complications, related to the use of a collagen-coated transvaginal mesh for anterior vaginal wall prolapse against a conventional anterior repair.Design Randomised controlled study.Setting Six departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark.Population A total of 138 women, of 55 years of age or older, admitted for stage ≥2 anterior vaginal wall prolapse.Methods The women scheduled for primary anterior vaginal wall prolapse surgery were randomised between conventional anterior colporrhaphy and surgery with a collagen-coated prolene mesh. All patients were evaluated using the Pelvic Organ Prolapse Quantification (POP-Q) assessment before and after surgery. Symptoms related to pelvic organ prolapse were evaluated using the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Pelvic Floor Distress Inventory (PFDI-20).Main outcome measures Objective cure, defined as POP-Q stage <2 prolapse at the 1-and 3-year follow-ups. Furthermore, mesh exposure and dyspareunia were also recorded.Results In total, 138 patients (70 from the mesh group versus 68 from the conventional anterior colporrhaphy group) out of 160 (86.3%) participated in the 3-year follow-up. POP-Q revealed an objective anatomic cure for 88.1 and 91.4%, respectively, in the mesh group at the 1-and 3-year follow-ups, compared with 39.9 and 41.2% in the colporrhaphy group. No difference between the groups was observed regarding PFIQ-7, PFDI-20, and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores. The number of mesh exposures did not change during the study period and all exposures were minor.Conclusion Our study demonstrates that although the objective outcome was superior in the mesh group, the use of mesh had no impact on the subjective outcome.Keywords Anterior colporrhaphy, erosion, pelvic organ prolapse, synthetic mesh.Tweetable abstract POP-Q deteriorates after anterior prolapse surgery but remains stable in women with mesh implantation.Please cite this paper as: Rudnicki M, Laurikainen E, Pogosean R, Kinne I, Jakobsson U, Teleman P. A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG 2016;123:136-142.

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“…Surgical management of POP is a challenging condition for pelvic reconstructive surgeons, with approximately one‐third of prolapse procedures performed for recurrence . Among the different forms of POP, cystocele can be a particularly difficult condition to manage with a recurrence rate after traditional repair between 40 and 63% and up to 90% in some women . For this reason clinicians dealing with POP have been in a constant search for surgical techniques to improve outcomes.…”

Section: Introductionmentioning

confidence: 99%