Abstract | OBJECTIVE: To investigate the anatomical cure rate and complications related to collagen-coated mesh for cystocele, compared with a conventional anterior colporrhaphy. DESIGN: A randomised controlled study. SETTING: Six departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark. POPULATION: Women aged 55 years or older, referred for surgery with a prolapse of the anterior vaginal wall of stage 2 or higher. METHODS: Women scheduled for primary cystocoele surgery were randomised to either anterior colporrhaphy or a collagen-coated Prolene mesh. Power analysis indicated that 130 patients had to be randomised. All patients were evaluated using the Pelvic Organ Prolapse-Quantification (POP-Q) measurement. Quality of life, symptoms, and sexual function were evaluated using the Pelvic Floor Impact Questionnaire, the Pelvic Floor Distress Inventory, and the Pelvic Organ Prolapse/ Urinary Incontinence Sexual Questionnaire. MAIN OUTCOME MEASURES: The primary outcome was objective cure, defined as prolapse below POP-Q stage 2 at the 12-months follow-up. Secondary outcomes were quality of life, symptoms, and presence (or not) of complications. RESULTS: In total, 161 women were randomised to either anterior colporrhaphy or mesh (participant ages 64.9 ± 6.4 years versus 64.7 ± 6.6 years, respectively; mean ± SD). The objective cure rate was 39.8% (95% CI 28.6-50.9%) in the anterior colporrhaphy group, compared with 88.1% (95% CI 80.7-95.6%) in the mesh group (P < 0.001). Vaginal mesh exposure occurred in ten women (13.3%) and dyspareunia occurred in two women (2.7%, not significant) in the mesh group at the 12-months follow-up. Questionnaires revealed no difference between the groups. CONCLUSIONS: Our study demonstrates a significantly improved objective cure rate associated with a high exposure rate among women with mesh surgery as opposed to conventional surgery.
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Authors | M Rudnicki, E Laurikainen, R Pogosean, I Kinne, U Jakobsson, P Teleman |
Journal | BJOG : an international journal of obstetrics and gynaecology
(BJOG)
Vol. 121
Issue 1
Pg. 102-10; discussion 110-1
(Jan 2014)
ISSN: 1471-0528 [Electronic] England |
PMID | 24118844
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2013 Royal College of Obstetricians and Gynaecologists. |
Chemical References |
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Topics |
- Aged
- Aged, 80 and over
- Collagen
- Cystocele
(surgery)
- Denmark
- Female
- Finland
- Humans
- Middle Aged
- Norway
- Quality of Life
- Sexuality
- Surgical Mesh
- Surveys and Questionnaires
- Sweden
- Treatment Outcome
- Vagina
(surgery)
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