A randomized controlled trial comparing anatomical and functional outcome between vaginal colposuspension and transvaginal mesh

Lamblin, G.; Van-Nieuwenhuyse, A.; Chabert, Philippe; Lebail-Carval, K; Moret, Stéphanie; Méllier, G

doi:10.1007/s00192-014-2344-7

Cited by 39 publications

(26 citation statements)

References 25 publications

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“…At baseline there was almost as much distress from urinary symptoms as from pelvic organ prolapse, and both these symptoms of pelvic floor dysfunction improved significantly after the operation. These results are comparable with previous studies on the use of mesh in pelvic organ prolapse repair [3,14,[18][19][20].…”

Section: Commentsupporting

confidence: 90%

“…Although the restoration of vaginal topography often results in improvements in pelvic organ prolapse symptoms the incongruence between objective and subjective outcomes in pelvic organ prolapse surgery is well established [1][2][3]. As a consequence, the focus of pelvic organ prolapse surgery has pivoted towards patients centered outcomes and quality of life measures, [4-6] rather than simply measuring pelvic anatomy outcomes of surgery.…”

Section: Introductionmentioning

confidence: 99%

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Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Rahkola-Soisalo

Altman

Falconer

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective: To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold TM System. Study design: In this prospective cohort study, women (n = 207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold TM Vaginal Support System. Follow-up for quality of life was performed at 12 months after surgery, and assessed by the PFDI-20, and PFIQ-7, and sexual function by the PISQ-12. We used odds ratios (ORs) with 95% confidence intervals (CIs) for outcome association analyses using logistic regression.Results: At one-year follow-up majority of women experienced an overall postoperative improvement in quality of life (p < 0.001). One year after surgery Uphold TM operation alone increased the risk for prolapse related bother as compared to Uphold TM combined with anterior colporraphy (POP-IQ-7; OR 2.1; 95% CI 1.01-4.3). The frequency of dyspareunia decreased postoperatively (p = 0.004), however, after one-year, overall sexual function deteriorated significantly (p < 0.001). The worsening in sexual function scores was mainly attributed to the partner related domain, whereas the behavioral-emotive and physical domains showed no significant changes. Conclusion: Apical prolapse repair using Uphold TM improved quality of life among our patients but worsened overall sexual function postoperatively. 2016 Elsevier Ireland Ltd. All rights reserved. IntroductionAlthough the restoration of vaginal topography often results in improvements in pelvic organ prolapse symptoms the incongruence between objective and subjective outcomes in pelvic organ prolapse surgery is well established [1][2][3]. As a consequence, the focus of pelvic organ prolapse surgery has pivoted towards patients centered outcomes and quality of life measures, [4-6] rather than simply measuring pelvic anatomy outcomes of surgery.In women after pelvic organ prolapse surgery quality of life measures may entail a variety of domains of which the effects on sexual function has received perhaps the most attention [7]. Nonetheless, it remains unclear how, and to what extent, sexual dysfunction relates to pelvic reconstructive surgery. Some studies suggest that sexual dysfunction is a common sequela after mesh augmented reconstructive surgery [8,9], others suggest that surgery has no effect [10][11][12], or even improve sexual function domains [13,14]. Ambiguous results have also been shown for other quality of life domains in relation pelvic organ prolapse surgery.We have previously reported on the safety and efficacy outcomes and subjective relief of condition specific symptoms after using the Uphold TM Vaginal Support System [15]. In the present study we assessed quality of life and sexual function outcomes following Uphold TM surgery in a prospective cohort of women with apical prolapse and with or without concurrent cystocele.

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Section: Commentsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Rahkola-Soisalo

Altman

Falconer

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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“…1). The surgical technique was as previously described by Lamblin et al [5]. For both the Elevate and Perigee groups, a midline incision was made in the absence of hysterectomy.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…Secondary endpoints were objective anterior success, functional results based on PFDI-20, PFIQ-7 and PISQ-12 scores at baseline and 1 and 2 years, and complications including perioperative and mesh-related complications (vaginal exposure, vaginal pain, mesh shrinkage) and postoperative stress urinary incontinence. Mesh shrinkage was defined as retraction of the stretched implant found by palpation on clinical examination [5]. In the two groups, vaginal pain was assessed during vaginal examination.…”

Section: Reported Outcomesmentioning

confidence: 99%

“…Cystocele, whether isolated or associated with apical and/ or posterior prolapse, is found in 80 % of patients with genital prolapse [1]. Recent randomized trials and meta-analyses have shown that vaginal mesh kits improve anatomic outcome in grade ≥3 anterior cystocele compared with autologous techniques [3][4][5][6]. While anatomic repair is better after mesh surgery, quality of life and patient satisfaction are also essential and must be analyzed.…”

Section: Introductionmentioning

confidence: 99%

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A retrospective comparison of two vaginal mesh kits in the management of anterior and apical vaginal prolapse: long-term results for apical fixation and quality of life

et al. 2016

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The use of the Elevate Ant mesh was associated with significantly better apical correction at 2 years. Function improved in both groups, but with a significantly better PFDI-20 score in the Elevate Ant group at 1 and 2 years. The postoperative stress urinary incontinence rate, however, tended to be greater in the Elevate Ant group. The results need confirming with longer follow-up of these cohorts and in randomized studies.

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Surgery for women with anterior compartment prolapse

Maher

Feiner

Baeßler

et al. 2016

Cochrane Database of Systematic Reviews

160

113

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Biological graft repair or absorbable mesh provides minimal advantage compared with native tissue repair.Native tissue repair was associated with increased awareness of prolapse and increased risk of repeat surgery for prolapse and recurrence of anterior compartment prolapse compared with polypropylene mesh repair. However, native tissue repair was associated with reduced risk of de novo SUI, reduced bladder injury, and reduced rates of repeat surgery for prolapse, stress urinary incontinence and mesh exposure (composite outcome).Current evidence does not support the use of mesh repair compared with native tissue repair for anterior compartment prolapse owing to increased morbidity.Many transvaginal polypropylene meshes have been voluntarily removed from the market, and newer light-weight transvaginal meshes that are available have not been assessed by RCTs. Clinicans and women should be cautious when utilising these products, as their safety and efficacy have not been established.

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A randomized controlled trial comparing anatomical and functional outcome between vaginal colposuspension and transvaginal mesh

Abstract: The vaginal colposuspension technique of anterior vaginal wall prolapse repair gave good anatomical and functional results at 2 years. Transobturator vaginal mesh gave better 2-year anatomical results than vaginal colposuspension, with overall improvement in QoL in both groups.

Cited by 39 publications

References 25 publications

Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse—A prospective multicenter study

A retrospective comparison of two vaginal mesh kits in the management of anterior and apical vaginal prolapse: long-term results for apical fixation and quality of life

Surgery for women with anterior compartment prolapse

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