Long-term outcomes of a randomized controlled trial comparing trans-obturator vaginal mesh with native tissue repair in the treatment of anterior vaginal wall prolapse

被引:18
作者
Allegre, Lucie [1 ]
Callewaert, Geertje [1 ,2 ,3 ]
Alonso, Sandrine [4 ]
Cornille, Arnaud [5 ]
Fernandez, Herve [6 ]
Eglin, Georges [7 ]
de Tayrac, Renaud [1 ]
机构
[1] Univ Montpellier, Dept Obstet & Gynecol, CHU Nimes, Nimes, France
[2] Univ Hosp Leuven, Dept Obstet & Gynecol, Leuven, Belgium
[3] Nimes Univ Hosp, Dept Obstet & Gynecol, Pl Pr Debre, F-30029 Nimes 9, France
[4] Univ Montpellier, CHU Nimes, Dept Biostat Epidemiol Publ Hlth & Innovat Method, Nimes, France
[5] Clin Beau Soleil, Dept Obstet & Gynecol, Montpellier, France
[6] Kremin Bicetre Hosp, Dept Obstet & Gynecol, Kremin Bicetre, France
[7] Clin Champeau, Dept Obstet & Gynecol, Beziers, France
关键词
Long-term outcome; Pelvic organ prolapse; Cystocele; Vaginal surgery; Polypropylene mesh; Anterior colporrhaphy; PELVIC ORGAN PROLAPSE; TRANSVAGINAL MESH; LIFETIME RISK; SURGERY; STANDARDIZATION; INCONTINENCE; COLPORRHAPHY; TERMINOLOGY; EXPOSURE;
D O I
10.1007/s00192-019-04073-x
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Introduction and hypothesis The aim of this study was to report the long-term subjective and objective outcomes after transvaginal mesh (TVM) or native tissue repair. Methods Prospective, randomized, multicenter study conducted between April 2005 and December 2009 comparing anterior colporrhaphy with trans-obturator vaginal mesh (Pelvitex/Ugytex (R), Sofradim, Trevoux, France) for the treatment of anterior vaginal wall prolapse. The primary endpoint was functional recurrence rate 5-8 years after surgery. Secondary endpoints consisted of anatomical results, mesh-related morbidity and patient satisfaction measured through validated questionnaires. Results Of the 147 women originally included, 75 (51%) were successfully re-contacted a median of 7 years after the initial surgery. The primary outcome, subjective recurrence of prolapse, was similar between the TVM and the anterior colporrhaphy groups (31 vs 34% respectively). Anatomical recurrence was less likely in the TVM group (67 vs 24%, p = 0.004). Mesh exposure occurred in 4 of the 39 patients (13%) during follow-up, 2 of which had a surgical reintervention. Reintervention for prolapse took place in 7 patients (9%). Conclusion Seven-year follow-up showed similar functional outcomes for mesh and native tissue repair in anterior vaginal wall prolapse. TVM did not reduce repeat surgery in the long term; it did, however, reduce anatomical recurrence. Mesh exposure rates were relatively high, but no difference in outcome of pain or dyspareunia was noted.
引用
收藏
页码:745 / 753
页数:9
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