Analysis of the learning curve of bilateral anterior sacrospinous ligament suspension associated with anterior mesh repair

Tayrac, Renaud de; Faillie, Jean‐Luc; Gaillet, S.; Boileau, L.; Triopon, G.; Letouzey, V.

doi:10.1016/j.ejogrb.2012.09.004

Cited by 21 publications

(12 citation statements)

References 16 publications

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“…There is, however, a clear link between volume and patient morbidity, as well as, mortality in many fields. In concurrence with our results, a study by De Tayrac et al showed a negative association between an increasing number of pelvic organ prolapse mesh procedures performed and the rate of complications [23]. Thus, emerging data suggest that the assumed relationship between volume and morbidity is valid also for urogynecological mesh surgery.…”

Section: Discussionsupporting

confidence: 92%

Long-term outcomes of pelvic organ prolapse repair using a mesh-capturing device when comparing single- versus multicenter use

Falconer

Altman

Poutakidis

et al. 2020

Arch Gynecol Obstet

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Purpose The aim of this study was to compare long-term effects of high-volume surgery at a single-center to multicenter use when using a mesh-capturing device for pelvic organ prolapse (POP) repair. Methods Five years after surgery 101 (88%) at the single center were compared with 164 (81.2%) in the multicenter trial. Outcome measurements included clinical examination, prolapse-specific symptom questionnaires [Pelvic Floor Distress Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire—short form (PFIQ-7), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12)] and pain estimation by VAS (0–10). Results Optimal apical segment outcome was 95% in the single- compared to 83.3% in the multicenter study (p < 0.001). POP recurrence in the anterior and posterior walls (POP-Q, Ba and Bp ≥ 0) was more common at the multicenter as compared to the single center [(19.8% vs 5.4%) and (26% vs 2.7%), (p < 0.001)]. Reoperations for POP and mesh-related complications were more frequent in the multicenter study [31/202 (15.3%) vs 7/116 (6.1%), p < 0.001]. Total PFDI-20, PFIQ-7 and PISQ-12 scores were comparable between the cohorts. There were no significant differences in overall pain scores in-between the cohorts during follow-up. At the single center, 1/81 patients (1.2%) had VAS 7/10, i.e. severe pain, as compared to 3/131 (2.3%) in the multicenter study (p = 0.277). Conclusions Despite the high objective and subjective long-term effectiveness of the procedure in both regular use, and at a high-volume center, centralizing the use of a standardized capturing-device guided transvaginal mesh for POP repair reduced secondary interventions by more than half.

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Section: Discussionsupporting

confidence: 92%

Long-term outcomes of pelvic organ prolapse repair using a mesh-capturing device when comparing single- versus multicenter use

Falconer

Altman

Poutakidis

et al. 2020

Arch Gynecol Obstet

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“…This study, similar to ours, involved surgical teams that were very experienced with TVM. It has been reported that mesh exposure and complications decrease along the learning curve [22][23][24]. The fact that all surgeons were experienced in the approach they used may explain our results.…”

Section: Discussionmentioning

confidence: 65%

Safety of Vaginal Mesh Surgery Versus Laparoscopic Mesh Sacropexy for Cystocele Repair: Results of the Prosthetic Pelvic Floor Repair Randomized Controlled Trial

et al. 2018

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“…Statistical analysis of the learning curve of bilateral anterior sacrospinous ligament suspension associated with anterior mesh repair in a single centre showed that the risk of major complications was reduced by approximately 30 % every ten procedures (HR = 0.71, 95 % CI 0.53-0.95). The rate of mesh exposure was found to be 3.6 % [15].…”

Section: Discussionmentioning

confidence: 98%

Perioperative outcomes and prospective patient reported outcome measures for transvaginal mesh surgery

Balchandra

Marsh

Landon

2015

Arch Gynecol Obstet

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Analysis of the learning curve of bilateral anterior sacrospinous ligament suspension associated with anterior mesh repair

Cited by 21 publications

References 16 publications

Long-term outcomes of pelvic organ prolapse repair using a mesh-capturing device when comparing single- versus multicenter use

Long-term outcomes of pelvic organ prolapse repair using a mesh-capturing device when comparing single- versus multicenter use

Safety of Vaginal Mesh Surgery Versus Laparoscopic Mesh Sacropexy for Cystocele Repair: Results of the Prosthetic Pelvic Floor Repair Randomized Controlled Trial

Perioperative outcomes and prospective patient reported outcome measures for transvaginal mesh surgery

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