A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse

作者：Halaska Michael; Maxova Katerina; Sottner Oldrich; Svabik Kamil; Mlcoch Michal; Kolarik Dusan; Mala Ivana; Krofta Ladislav; Halaska Michael J^*

来源：American Journal of Obstetrics and Gynecology, 2012, 207(4): 301.e1.

DOI：10.1016/j.ajog.2012.08.016

• pelvic organ prolapse quantification prolapse
• Prolift
• quality-of-life questionnaires
• sacrospinous fixation

OBJECTIVE: The objective of the study was to compare recurrence and complication rates for sacrospinous fixation (SSF) and prolene mesh techniques for the primary treatment of posthysterectomy vaginal vault prolapse. %26lt;br%26gt;STUDY DESIGN: Patients undergoing surgery for vault prolapse were included in a multicenter, randomized, controlled study comparing SSF or total mesh (Prolift; Gynecare/Ethicon, Somerville, NJ). The examination included pelvic organ prolapse quantification, urodynamics, ultrasound, and quality-of-life (QoL) questionnaires before and 3 and 12 months after surgery. %26lt;br%26gt;RESULTS: Of 168 randomized patients, 83 underwent SSF and 85 mesh repair. Prolapse recurrence after 12 months occurred in 39.4% of the SSF group and in 16.9% of the mesh group (P = .003). The mesh exposure rate was 20.8%. No difference in QoL improvement as well as of de novo stress urinary incontinence and overactive bladder onset was found. %26lt;br%26gt;CONCLUSION: Mesh exposure occurrence was balanced against a lower prolapse recurrence rate in the patients undergoing mesh surgery compared with those undergoing SSF.

• 出版日期2012-10