STUDY OBJECTIVE: To compare the effectiveness and safety of 2 anterior transobturator mesh methods for treating anterior vaginal wall prolapse.
DESIGN: Randomized controlled study (Canadian Task Force classification I).
SETTING: University hospital.
PATIENTS: Eighty-seven women with anterior vaginal wall prolapse stage ≥2 (Pelvic Organ Prolapse Quantification [POP-Q]) underwent an anterior transobturator mesh procedure using macropore polypropylene mesh.
INTERVENTIONS Forty-five patients underwent the operation via the conventional 4-point, full-sized mesh method, and 42 patients underwent the operation via a novel 2-point, half-sized mesh method.
MEASUREMENTS AND MAIN RESULTS:Patient characteristics were comparable between the 2 groups. The anatomic cure rate was significantly lower in the 2-point group compared with the 4-point group at 12 months after surgery (87.2% vs 100%; p = .03). Healing abnormalities were significantly higher in the 2-point group than in the 4-point group (12.8% vs 0%; p = .03). Bladder perforation (2.6% vs 0%), stress urinary incontinence (23.1% vs 22.5%), urinary frequency (12.8% vs 22.5%), and voiding difficulty and dyspareunia (0% vs 0%) were not statistically different between the 2 groups. At linear regression analysis, mean (SD) operation time did not differ between the 2 groups (74.9 [32.7] minutes vs 87.8 [36.7] minutes; p = .11).
CONCLUSION: Compared with the 4-point method, the 2-point anterior transobturator mesh method resulted in a lower rate of anatomic cure and a higher rate of healing abnormality.
Written by:
Yuk JS, Jin CH, Yi KW, Kim T, Hur JY, Shin JH. Are you the author?
Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
Reference: J Minim Invasive Gynecol. 2012 Nov-Dec;19(6):737-41.
doi: 10.1016/j.jmig.2012.08.769
PubMed Abstract
PMID: 23084678
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