ResearchUrogynecologyLaparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial
Section snippets
Materials and Methods
From the end of 2005, consecutive women referred to Wesley, Royal Brisbane's and Mater tertiary referral Urogynaecology unit with symptomatic stage 2 or greater (point C ≥ −1 pelvic organ prolapse quantification [POP-Q]) vaginal vault prolapse were eligible for inclusion. Recruitment was completed at the end of 2007. Exclusion criteria included those younger than 18 years of age, inability to comprehend questionnaires, to give informed consent or to return for review, vault prolapse < stage 2,
Results
The Figure details patients' progress through the study with 108 women of 142 potentially eligible, consenting to randomization and participation with 53 allocated LSC and 55 vaginal mesh repair. All completed at least 6 months follow-up. The randomization process was adequate with no differences between the 2 groups in demographics and preoperative variables as seen in Table 1. Wilcoxon test indicate no significant difference between treatment groups for preoperative POP-Q measurements except
Comment
The results indicate that both procedures had acceptable perioperative outcomes with the longer operating time being a disadvantage of the LSC that was offset by small but statistically significant reduction in blood loss, inpatient stay, catheter days, and return to activities of daily living in the LSC group as compared with the TVM group.
At mean 2 year review, the anatomic outcome saw a significant reduction in Aa, Ba, C, Ap, and Bp in both groups as compared with the preoperative
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The study was supported by competitive research grants from the Australian Gynaecological Endoscopy Society, 2007 and 2008, Sydney, Australia.
Cite this article as: Maher CF, Feiner B, DeCuyper EM, et al. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol 2011;204:360.e1-7.