Volume 8, Issue 3, May 2020, Page: 55-61
Laparoscopic Sacrocolpopexy vs Transvaginal Mesh Repair for Advanced Pelvic Organ Prolapse: 1 Year Results of a Multicenter Randomized Study
Juan Chen, Department of Obstetrics/Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
Tao Xu, Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
Xiaowei Zhang, Department of Gynecology, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China
Keqin Hua, Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
Mei Ji, Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
Luwen Wang, Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University and Henan Province Maternal and Child Health Care Hospital, Zhengzhou, China
Huicheng Xu, Department of Gynecology, Southwest Hospital of the Third Military Medical University, Chongqing, China
Jinghe Lang, Department of Obstetrics/Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
Abraham Morse, Department of Gynecology, Guangzhou Women and Children’ Medical Center, Guangzhou, China
Lan Zhu, Department of Obstetrics/Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
Received: Mar. 14, 2020;       Accepted: Apr. 17, 2020;       Published: May 12, 2020
DOI: 10.11648/j.jgo.20200803.12      View  274      Downloads  80
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.
Keywords
Pelvic Organ Prolapse, Laparoscopic Sacrocolpopexy, Transvaginal Mesh
To cite this article
Juan Chen, Tao Xu, Xiaowei Zhang, Keqin Hua, Mei Ji, Luwen Wang, Huicheng Xu, Jinghe Lang, Abraham Morse, Lan Zhu, Laparoscopic Sacrocolpopexy vs Transvaginal Mesh Repair for Advanced Pelvic Organ Prolapse: 1 Year Results of a Multicenter Randomized Study, Journal of Gynecology and Obstetrics. Vol. 8, No. 3, 2020, pp. 55-61. doi: 10.11648/j.jgo.20200803.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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