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- Title
A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial.
- Authors
Rudnicki, M; Laurikainen, E; Pogosean, R; Kinne, I; Jakobsson, U; Teleman, P
- Abstract
<bold>Objective: </bold>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.<bold>Design: </bold>Randomised controlled study.<bold>Setting: </bold>Six departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark.<bold>Population: </bold>A total of 138 women, of 55 years of age or older, admitted for stage ≥2 anterior vaginal wall prolapse.<bold>Methods: </bold>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).<bold>Main Outcome Measures: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.<bold>Tweetable Abstract: </bold>POP-Q deteriorates after anterior prolapse surgery but remains stable in women with mesh implantation.
- Subjects
DENMARK; FINLAND; NORWAY; SWEDEN; VAGINAL surgery; COLLAGEN; TRANSVAGINAL surgery; RANDOMIZED controlled trials; FOLLOW-up studies (Medicine); DYSPAREUNIA; PELVIC organ prolapse; COLPORRHAPHY; COMPARATIVE studies; GYNECOLOGIC surgery; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; QUALITY of life; QUESTIONNAIRES; RESEARCH; EVALUATION research; TREATMENT effectiveness; SURGICAL meshes; EQUIPMENT &; supplies; SURGERY
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2016, Vol 123, Issue 1, p136
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.13628