Backgrounds: Laparoscopic sacrocolpopexy is considered the most durable operation for the repair of advanced uterovaginal prolapse. However, there is still disagreement about whether the efficacy and safety of vaginally implanted mesh to address advanced uterovaginal prolapse is comparable to sacrocolpopexy. Our goal was to evaluate the anatomical and subjective outcomes of laparoscopic sacrocolpopexy versus transvaginal mesh in a randomized trial in China. Methods: A multicenter randomized trial was carried out at 6 tertiary hospitals in China. Patients with symptomatic advanced prolapse (stages III-IV) were enrolled. Between January 2013 and June 2014, a total of 100 women were randomized. 40 laparoscopic sacrocolpopexy procedures and 42 transvaginal mesh procedures were performed. Patients were randomized to undergo either laparoscopic sacrocolpopexy or transvaginal mesh. Results: At 1 year, the anatomic success rate was 92.5% in the laparoscopic sacrocolpopexy arm, compared with 83.3% in the transvaginal mesh group (P=0.35). Laparoscopic sacrocolpopexy was associated with better apical support. The laparoscopic sacrocolpopexy group had a longer operative time. Mesh exposures occurred in 2.5% of laparoscopic repairs vs. 2.4% of transvaginal mesh repairs. Conclusion: In a randomized trial, 1-year objective cure rates were not statistically different. However the success rate was 9.2% higher for laparoscopic sacrocolpopexy. The two procedures had comparable mesh exposure rates, and other complications were rare in both groups. Trial registration: clinicaltrials.gov (NCT01762384). The date of registration was Jan 7th, 2013. URL was https://clinicaltrials.gov/ct2/show/NCT01762384?term=NCT01762384&draw=2&rank=1.
| Published in | Journal of Gynecology and Obstetrics (Volume 8, Issue 3) |
| DOI | 10.11648/j.jgo.20200803.12 |
| Page(s) | 55-61 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Pelvic Organ Prolapse, Laparoscopic Sacrocolpopexy, Transvaginal Mesh
| [1] | Wu JM, Matthews CA, Conover MM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014; 123: 1201-1206. |
| [2] | Clark AL, Gregory T, Smith VJ, et al. Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2003; 189: 1261-1267. |
| [3] | Vergeldt TF, Weemhoff M, IntHout J,, et al. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015; 26: 1559-1573. |
| [4] | Parkes IL, Shveiky D. Sacrocolpopexy for treatment of vaginal apical prolapse: evidence-based surgery. J Minim Invasive Gynecol. 2014; 21: 546-557. |
| [5] | Nygaard IE, McCreery R, Brubaker L,, et al. Pelvic Floor Disorders Network. Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol. 2004; 104: 805-823. |
| [6] | Ganatra AM, Rozet F, Sanchez-Salas R,, et al. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009; 55: 1089-1103. |
| [7] | Liang S, Zhu L, Song X,, et al. Long-term outcomes of modified laparoscopic sacrocolpopexy for advanced pelvic organ prolapse: a 3-year prospective study. Menopause. 2016; 23: 765-770. |
| [8] | Zhu L. Long-Term Outcomes of the Self-Cut Mesh-Related Modified Total Pelvic Reconstructive Surgical Repair for Pelvic Organ Prolapse in China: A 7-Year Prospective Cohort Study. J Minim Invasive Gynecol. 2015; 22: S252–S253. |
| [9] | Maher CF, Feiner B, DeCuyper EM, et al. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol. 2011; 204: 360. e1-7. |
| [10] | Davila GW, Baessler K, Cosson M, et al. Selection of patients in whom vaginal graft use may be appropriate. Consensus of the 2nd IUGA Grafts Roundtable: optimizing safety and appropriateness of graft use in transvaginal pelvic reconstructive surgery. Int Urogynecol J. 2012; 23 Suppl 1: S7-14. |
| [11] | Zhu L, Yu S, Xu T, et al. Chinese validation of the Pelvic Floor Impact Questionnaire Short Form. Menopause. 2011; 18: 1030-1033. |
| [12] | Ma Y, Xu T, Zhang Y, et al. Validation of the Chinese version of the Pelvic Floor Distress Inventory-20 (PFDI-20) according to the COSMIN checklist. Int Urogynecol J. 2019; 30: 1127-1139. |
| [13] | Zhu L, Yu S, Xu T, et al. Validation of the Chinese version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12). Int J Gynaecol Obstet. 2012; 116: 117-119. |
| [14] | Zhu L, Sun Z, Yu M, et al. Modified laparoscopic sacrocolpopexy with mesh for severe pelvic organ prolapse. Int J Gynaecol Obstet. 2013; 121: 170-172. |
| [15] | Zhu L, Lang J, Sun Z, et al. Pelvic reconstruction with mesh for advanced pelvic organ prolapse: a new economic surgical method. Menopause. 2011; 18: 328-332. |
| [16] | Srikrishna S, Robinson D, Cardozo L. Validation of the Patient Global Impression of Improvement (PGI-I) for urogenital prolapse. Int Urogynecol J. 2010; 21: 523-528. |
| [17] | Abraha I, Montedori A. Modified intention to treat reporting in randomised controlled trials: systematic review. BMJ. 2010; 14; 340: c2697. |
| [18] | Shveiky D, Iglesia CB, Sokol AI,, et al. Robotic sacrocolpopexy versus vaginal colpopexy with mesh: choosing the right surgery for anterior and apical prolapse. Female Pelvic Med Reconstr Surg. 2010; 16: 121-127. |
| [19] | Sanses TV, Shahryarinejad A, Molden S, et al; Fellows' Pelvic Research Network. Anatomic outcomes of vaginal mesh procedure (Prolift) compared with uterosacral ligament suspension and abdominal sacrocolpopexy for pelvic organ prolapse: a Fellows' Pelvic Research Network study. Am J Obstet Gynecol. 2009; 201: 519. e1-8. |
| [20] | Bataller E, Ros C, Anglès S, et al. Anatomical Outcomes 1 Year after Pelvic Organ Prolapse Surgery in Patients with and without a Uterus at a High Risk of Recurrence: A Randomised Controlled Trial Comparing Laparoscopic Sacrocolpopexy/Cervicopexy and Anterior Vaginal Mesh. Int Urogynecol J. 2019; 30: 545-555. |
| [21] | Lucot JP, Cosson M, Bader G, et al. Safety of Vaginal Mesh Surgery Versus Laparoscopic Mesh Sacropexy for Cystocele Repair: Results of the Prosthetic Pelvic Floor Repair Randomized Controlled Trial. Eur Urol. 2018; 74: 167-176. |
| [22] | Dandolu V, Akiyama M, Allenback G,, et al. Mesh complications and failure rates after transvaginal mesh repair compared with abdominal or laparoscopic sacrocolpopexy and to native tissue repair in treating apical prolapse. Int Urogynecol J. 2017; 28: 215-222. |
APA Style
Juan Chen, Tao Xu, Xiaowei Zhang, Keqin Hua, Mei Ji, et al. (2020). Laparoscopic Sacrocolpopexy vs Transvaginal Mesh Repair for Advanced Pelvic Organ Prolapse: 1 Year Results of a Multicenter Randomized Study. Journal of Gynecology and Obstetrics, 8(3), 55-61. https://doi.org/10.11648/j.jgo.20200803.12
ACS Style
Juan Chen; Tao Xu; Xiaowei Zhang; Keqin Hua; Mei Ji, et al. Laparoscopic Sacrocolpopexy vs Transvaginal Mesh Repair for Advanced Pelvic Organ Prolapse: 1 Year Results of a Multicenter Randomized Study. J. Gynecol. Obstet. 2020, 8(3), 55-61. doi: 10.11648/j.jgo.20200803.12
AMA Style
Juan Chen, Tao Xu, Xiaowei Zhang, Keqin Hua, Mei Ji, et al. Laparoscopic Sacrocolpopexy vs Transvaginal Mesh Repair for Advanced Pelvic Organ Prolapse: 1 Year Results of a Multicenter Randomized Study. J Gynecol Obstet. 2020;8(3):55-61. doi: 10.11648/j.jgo.20200803.12
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.jgo.20200803.12,
author = {Juan Chen and Tao Xu and Xiaowei Zhang and Keqin Hua and Mei Ji and Luwen Wang and Huicheng Xu and Jinghe Lang and Abraham Morse and Lan Zhu},
title = {Laparoscopic Sacrocolpopexy vs Transvaginal Mesh Repair for Advanced Pelvic Organ Prolapse: 1 Year Results of a Multicenter Randomized Study},
journal = {Journal of Gynecology and Obstetrics},
volume = {8},
number = {3},
pages = {55-61},
doi = {10.11648/j.jgo.20200803.12},
url = {https://doi.org/10.11648/j.jgo.20200803.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20200803.12},
abstract = {Backgrounds: Laparoscopic sacrocolpopexy is considered the most durable operation for the repair of advanced uterovaginal prolapse. However, there is still disagreement about whether the efficacy and safety of vaginally implanted mesh to address advanced uterovaginal prolapse is comparable to sacrocolpopexy. Our goal was to evaluate the anatomical and subjective outcomes of laparoscopic sacrocolpopexy versus transvaginal mesh in a randomized trial in China. Methods: A multicenter randomized trial was carried out at 6 tertiary hospitals in China. Patients with symptomatic advanced prolapse (stages III-IV) were enrolled. Between January 2013 and June 2014, a total of 100 women were randomized. 40 laparoscopic sacrocolpopexy procedures and 42 transvaginal mesh procedures were performed. Patients were randomized to undergo either laparoscopic sacrocolpopexy or transvaginal mesh. Results: At 1 year, the anatomic success rate was 92.5% in the laparoscopic sacrocolpopexy arm, compared with 83.3% in the transvaginal mesh group (P=0.35). Laparoscopic sacrocolpopexy was associated with better apical support. The laparoscopic sacrocolpopexy group had a longer operative time. Mesh exposures occurred in 2.5% of laparoscopic repairs vs. 2.4% of transvaginal mesh repairs. Conclusion: In a randomized trial, 1-year objective cure rates were not statistically different. However the success rate was 9.2% higher for laparoscopic sacrocolpopexy. The two procedures had comparable mesh exposure rates, and other complications were rare in both groups. Trial registration: clinicaltrials.gov (NCT01762384). The date of registration was Jan 7th, 2013. URL was https://clinicaltrials.gov/ct2/show/NCT01762384?term=NCT01762384&draw=2&rank=1.},
year = {2020}
}
TY - JOUR T1 - Laparoscopic Sacrocolpopexy vs Transvaginal Mesh Repair for Advanced Pelvic Organ Prolapse: 1 Year Results of a Multicenter Randomized Study AU - Juan Chen AU - Tao Xu AU - Xiaowei Zhang AU - Keqin Hua AU - Mei Ji AU - Luwen Wang AU - Huicheng Xu AU - Jinghe Lang AU - Abraham Morse AU - Lan Zhu Y1 - 2020/05/12 PY - 2020 N1 - https://doi.org/10.11648/j.jgo.20200803.12 DO - 10.11648/j.jgo.20200803.12 T2 - Journal of Gynecology and Obstetrics JF - Journal of Gynecology and Obstetrics JO - Journal of Gynecology and Obstetrics SP - 55 EP - 61 PB - Science Publishing Group SN - 2376-7820 UR - https://doi.org/10.11648/j.jgo.20200803.12 AB - Backgrounds: Laparoscopic sacrocolpopexy is considered the most durable operation for the repair of advanced uterovaginal prolapse. However, there is still disagreement about whether the efficacy and safety of vaginally implanted mesh to address advanced uterovaginal prolapse is comparable to sacrocolpopexy. Our goal was to evaluate the anatomical and subjective outcomes of laparoscopic sacrocolpopexy versus transvaginal mesh in a randomized trial in China. Methods: A multicenter randomized trial was carried out at 6 tertiary hospitals in China. Patients with symptomatic advanced prolapse (stages III-IV) were enrolled. Between January 2013 and June 2014, a total of 100 women were randomized. 40 laparoscopic sacrocolpopexy procedures and 42 transvaginal mesh procedures were performed. Patients were randomized to undergo either laparoscopic sacrocolpopexy or transvaginal mesh. Results: At 1 year, the anatomic success rate was 92.5% in the laparoscopic sacrocolpopexy arm, compared with 83.3% in the transvaginal mesh group (P=0.35). Laparoscopic sacrocolpopexy was associated with better apical support. The laparoscopic sacrocolpopexy group had a longer operative time. Mesh exposures occurred in 2.5% of laparoscopic repairs vs. 2.4% of transvaginal mesh repairs. Conclusion: In a randomized trial, 1-year objective cure rates were not statistically different. However the success rate was 9.2% higher for laparoscopic sacrocolpopexy. The two procedures had comparable mesh exposure rates, and other complications were rare in both groups. Trial registration: clinicaltrials.gov (NCT01762384). The date of registration was Jan 7th, 2013. URL was https://clinicaltrials.gov/ct2/show/NCT01762384?term=NCT01762384&draw=2&rank=1. VL - 8 IS - 3 ER -
Information
Email: