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Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial
Article first published online: 7 JUL 2009
© 2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 116, Issue 10, pages 1380–1386, September 2009
How to Cite
Carey, M., Higgs, P., Goh, J., Lim, J., Leong, A., Krause, H. and Cornish, A. (2009), Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology, 116: 1380–1386. doi: 10.1111/j.1471-0528.2009.02254.x
- Issue published online: 10 AUG 2009
- Article first published online: 7 JUL 2009
- Accepted 28 April 2009. Published Online 7 July 2009.
- pelvic organ prolapse;
- randomised controlled trial
Objective To compare vaginal repair augmented by mesh with traditional colporrhaphy for the treatment of pelvic organ prolapse.
Design Prospective randomised controlled trial.
Setting Tertiary teaching hospital.
Population One hundred and thirty-nine women with stage ≥2 prolapse according to the pelvic organ prolapse quantification (POP-Q) system requiring both anterior and posterior compartment repair.
Methods Subjects were randomised to anterior and posterior vaginal repair with mesh augmentation (mesh group, n = 69) or traditional anterior and posterior colporrhaphy (no mesh group, n = 70).
Main outcome measures The primary outcome was the absence of POP-Q stage ≥2 prolapse at 12 months. Secondary outcomes were symptoms, quality-of-life outcomes and satisfaction with surgery. Complications were also reported.
Results For subjects attending the 12-month review, success in the mesh group was 81.0% (51 of 63 subjects) compared with 65.6% (40/61) in the no mesh group and was not significantly different (P-value = 0.07). A high level of satisfaction with surgery and improvements in symptoms and quality-of-life data were observed at 12 months compared to baseline in both groups, but there was no significant difference in these outcomes between the two groups. Vaginal mesh exposure occurred in four women in the mesh group (5.6%). De novo dyspareunia was reported by five of 30 (16.7%) sexually active women in the mesh group and five of 33 (15.2%) in the no mesh group at 12 months.
Conclusion In this study, vaginal surgery augmented by mesh did not result in significantly less recurrent prolapse than traditional colporrhaphy 12 months following surgery.