Long-term outcomes of primary cystocele ...
Document type :
Article dans une revue scientifique: Article original
DOI :
PMID :
Permalink :
Title :
Long-term outcomes of primary cystocele repair by transvaginal mesh surgery versus laparoscopic mesh sacropexy: extended follow-up of the PROSPERE multicentre randomised trial
Author(s) :
Lucot, J. P. [Auteur]
Cosson, Michel [Auteur]
Laboratoire de Mécanique, Multi-physique, Multi-échelle (LaMcube) - UMR 9013
Verdun, S. [Auteur]
Debodinance, P. [Auteur]
Bader, G. [Auteur]
Campagne-Loiseau, S. [Auteur]
Salet-Lizee, D. [Auteur]
Akladios, C. [Auteur]
Ferry, P. [Auteur]
De Tayrac, R. [Auteur]
Delporte, P. [Auteur]
Curinier, S. [Auteur]
Deffieux, X. [Auteur]
Blanc, S. [Auteur]
Capmas, P. [Auteur]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Fritel, X. [Auteur]
Fauconnier, A. [Auteur]
Cosson, Michel [Auteur]
Laboratoire de Mécanique, Multi-physique, Multi-échelle (LaMcube) - UMR 9013
Verdun, S. [Auteur]
Debodinance, P. [Auteur]
Bader, G. [Auteur]
Campagne-Loiseau, S. [Auteur]
Salet-Lizee, D. [Auteur]
Akladios, C. [Auteur]
Ferry, P. [Auteur]
De Tayrac, R. [Auteur]
Delporte, P. [Auteur]
Curinier, S. [Auteur]
Deffieux, X. [Auteur]
Blanc, S. [Auteur]
Capmas, P. [Auteur]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Fritel, X. [Auteur]
Fauconnier, A. [Auteur]
Journal title :
BJOG: An International Journal of Obstetrics and Gynaecology
Abbreviated title :
BJOG
Volume number :
129
Pages :
p. 127-137
Publication date :
2022-01
ISSN :
1471-0528
English keyword(s) :
Genital prolapse
laparoscopic sacropexy
transvaginal mesh
laparoscopic sacropexy
transvaginal mesh
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Objective
To compare the effectiveness and safety of laparoscopic sacropexy (LS) and transvaginal mesh (TVM) at 4 years.
Design
Extended follow up of a randomised trial.
Setting
Eleven centres.
Population
Women ...
Show more >Objective To compare the effectiveness and safety of laparoscopic sacropexy (LS) and transvaginal mesh (TVM) at 4 years. Design Extended follow up of a randomised trial. Setting Eleven centres. Population Women with cystocele stage ≥2 (pelvic organ prolapse quantification [POP-Q], aged 45–75 years without previous prolapse surgery. Methods Synthetic non-absorbable mesh placed in the vesicovaginal space and sutured to the promontory (LS) or maintained by arms through pelvic ligaments and/or muscles (TVM). Main outcome measures Functional outcomes (pelvic floor distress inventory [PFDI-20] as primary outcome); anatomical assessment (POP-Q), composite outcome of success; re-interventions for complications. Results A total of 220 out of 262 randomised patients have been followed at 4 years. PFDI-20 significantly improved in both groups and was better (but below the minimal clinically important difference) after LS (mean difference −7.2 points; 95% CI −14.0 to −0.05; P = 0.029). The improvement in quality of life and the success rate (LS 70%, 61–81% versus TVM 71%, 62–81%; hazard ratio 0.92, 95% CI 0.55–1.54; P = 0.75) were similar. POP-Q measurements did not differ, except for point C (LS −57 mm versus TVM −48 mm, P = 0.0093). The grade III or higher complication rate was lower after LS (2%, 0–4.7%) than after TVM (8.7%, 3.4–13.7%; hazard ratio 4.6, 95% CI 1.007–21.0, P = 0.049)). Conclusions Both techniques provided improvement and similar success rates. LS had a better benefit–harm balance with fewer re-interventions due to complications. TVM remains an option when LS is not feasible.Show less >
Show more >Objective To compare the effectiveness and safety of laparoscopic sacropexy (LS) and transvaginal mesh (TVM) at 4 years. Design Extended follow up of a randomised trial. Setting Eleven centres. Population Women with cystocele stage ≥2 (pelvic organ prolapse quantification [POP-Q], aged 45–75 years without previous prolapse surgery. Methods Synthetic non-absorbable mesh placed in the vesicovaginal space and sutured to the promontory (LS) or maintained by arms through pelvic ligaments and/or muscles (TVM). Main outcome measures Functional outcomes (pelvic floor distress inventory [PFDI-20] as primary outcome); anatomical assessment (POP-Q), composite outcome of success; re-interventions for complications. Results A total of 220 out of 262 randomised patients have been followed at 4 years. PFDI-20 significantly improved in both groups and was better (but below the minimal clinically important difference) after LS (mean difference −7.2 points; 95% CI −14.0 to −0.05; P = 0.029). The improvement in quality of life and the success rate (LS 70%, 61–81% versus TVM 71%, 62–81%; hazard ratio 0.92, 95% CI 0.55–1.54; P = 0.75) were similar. POP-Q measurements did not differ, except for point C (LS −57 mm versus TVM −48 mm, P = 0.0093). The grade III or higher complication rate was lower after LS (2%, 0–4.7%) than after TVM (8.7%, 3.4–13.7%; hazard ratio 4.6, 95% CI 1.007–21.0, P = 0.049)). Conclusions Both techniques provided improvement and similar success rates. LS had a better benefit–harm balance with fewer re-interventions due to complications. TVM remains an option when LS is not feasible.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Collections :
Submission date :
2023-11-15T06:12:59Z
2024-02-27T14:13:09Z
2024-02-27T14:13:09Z