Two-years results of native tissue versus vaginal mesh repair in the treatment of anterior prolapse according to different success criteria: A randomized controlled trial

Two-years results of native tissue versus vaginal mesh repair in the treatment of anterior prolapse according to different success criteria: A randomized controlled trial

Author Dias, Marcia M. Autor UNIFESP Google Scholar
Castro, Rodrigo de A. Autor UNIFESP Google Scholar
Bortolini, Maria Augusta Tezelli Autor UNIFESP Google Scholar
Delroy, Carlos Antonio Autor UNIFESP Google Scholar
Martins, Paulo C. F. Autor UNIFESP Google Scholar
Girão, Manoel João Batista Castello Autor UNIFESP Google Scholar
Sartori, Marair Gracio Ferreira Autor UNIFESP Google Scholar
Abstract AimsTo compare efficacy and safety of the traditional colporraphy and transvaginal polypropylene mesh for the treatment of advanced anterior vaginal prolapse according to different success criteria in two-year follow-up. MethodsIn this randomized controlled trial, women with anterior prolapse stage II or greater, with Ba point+1 (POP-Q quantification), were randomly assigned to have either anterior colporraphy (n=43) or transvaginal mesh repair (n=43). The primary outcome was to compare objective success rate under two success definitions: prolapse stage I (Ba <-1) and stage II (Ba <0). Secondary outcomes included complications and prolapse symptoms, satisfaction and quality of life (QoL). Intention to treat was used for the primary endpoint and per protocol analysis for the secondary outcomes. ResultsThe groups presented similar preoperative data. Thirty three patients from the colporraphy and 37 from the mesh groups completed two-year follow-up. Under Ba <-1 definition, success rate was 39.53% for both groups (P=1.00). Considering success as Ba <0, analysis favored the mesh group by 23% (51.16% and 74.42%

95% CI for difference: 3-43%

P=0.022). Patients from the mesh group were more satisfied after two years (81.8% and 97.3% for colporraphy and mesh, respectively, 15.5% difference

95% CI for difference 1-29%

P=0.032). Both procedures similarly improved women's symptoms and QoL. Some complications were observed, one being a 13.5% mesh exposure rate. ConclusionsTransvaginal synthetic mesh repair for advanced anterior vaginal prolapse provided higher anatomical success and satisfaction rates compared with traditional colporraphy. Both procedures equally improved quality of life. Neurourol. Urodynam. 35:509-514, 2016. (c) 2015 Wiley Periodicals, Inc.
Keywords anterior vaginal wall
colporraphy
mesh
pelvic organ prolapse
surgery
xmlui.dri2xhtml.METS-1.0.item-coverage Hoboken
Language English
Date 2016
Published in Neurourology And Urodynamics. Hoboken, v. 35, n. 4, p. 509-514, 2016.
ISSN 0733-2467 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 509-514
Origin http://dx.doi.org/10.1002/nau.22740
Access rights Closed access
Type Article
Web of Science ID WOS:000374304900013
URI https://repositorio.unifesp.br/handle/11600/56122

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