A multicenter, randomized trial comparing pelvic organ prolapse surgical treatment with native tissue and synthetic mesh: A 5-year follow-up study
| Autor: | Edmund Chada Baracat, Silvia da Silva Carramão, Paulo Francisco Ramos Margarido, Stergios K. Doumouchtsis, Jorge Milhem Haddad, Simone dos Reis Brandão da Silveira, Zsuzsanna I. K. Jarmy-Dibella, Antomio P. F. Auge, Claudinei Alves Rodrigues |
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| Rok vydání: | 2019 |
| Předmět: |
Reoperation
medicine.medical_specialty 5 year follow up Urology 030232 urology & nephrology Hysterectomy Polypropylenes Pelvic Organ Prolapse law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications Quality of life Randomized controlled trial law Recurrence Uterine Prolapse Surveys and Questionnaires medicine Humans Fascia Surgical treatment Aged Pelvic organ 030219 obstetrics & reproductive medicine Mesh repair business.industry Suture Techniques Middle Aged Plastic Surgery Procedures Surgical Mesh Surgery Treatment Outcome Native tissue Vagina Quality of Life Female Neurology (clinical) Sexual function business Follow-Up Studies |
| Zdroj: | Neurourology and urodynamicsREFERENCES. 39(3) |
| ISSN: | 1520-6777 |
| Popis: | Introduction The aim of this study was to compare long-term outcomes in patients who underwent either native tissue repair or monofilament macroporous polypropylene mesh. Methods This multicenter, randomized trial included-at the end of 5 years follow-up-122 women with severe pelvic organ prolapse, who were randomly assigned to undergo surgical treatment using native tissue repair (native tissue group, n = 59) or synthetic mesh repair (mesh group, n = 63). Cure criterion was when pelvic organ prolapse-quantification (POP-Q) point was ≤0. Quality of life was assessed using the prolapse quality-of-life questionnaire and sexual function with the quality of sexual function. Results Groups were homogeneous preoperatively with the exception of the previous pelvic surgery variable, which was higher in mesh (P = .019). Cure rate was significantly better for mesh group in the anterior compartment (P = .002) and in the combination of all compartments (P = .001). Native tissue group was significantly better when there was prolapse in the posterior and apical compartment (P = .031). In the quality of life analysis, mesh group showed a significant improvement compared with native tissue group (P = .004). Complications were significantly higher in mesh and recurrence in native tissue. Regarding the reoperation rate, there was no difference between groups, but native tissue had a higher reoperation rate due to recurrence (P = .031). Conclusions Outcomes in women with severe POP were better with mesh use than native tissue repair, both in the anterior compartment and in the multicompartmental prolapse after 5-year follow-up. Complications were more common in the mesh group and recurrences were more frequent in the native tissue group. |
| Databáze: | OpenAIRE |
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