Titre :

Long-term outcomes of primary cystocele repair by transvaginal mesh surgery versus laparoscopic mesh sacropexy: extended follow-up of the PROSPERE multicentre randomised trial

Auteur(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]

Titre de la revue :

BJOG: An International Journal of Obstetrics and Gynaecology

Nom court de la revue :

BJOG

Numéro :

129

Pagination :

p. 127-137

Date de publication :

2022-01

ISSN :

1471-0528

Mot(s)-clé(s) en anglais :

Genital prolapse
laparoscopic sacropexy
transvaginal mesh

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [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 ...
Lire la suite >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.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• Laboratoire de Mécanique, Multi-physique, Multi-échelle (LaMcube) - UMR 9013
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2023-11-15T06:12:59Z
2024-02-27T14:13:09Z