nach oben

International Urogynecology Journal

Erschienen in:

01.11.2011 | Original Article

Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review

verfasst von: Christopher M. Maher, Benny Feiner, Kaven Baessler, Cathryn M. A. Glazener

Erschienen in: International Urogynecology Journal | Ausgabe 11/2011

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

A previous version of the Cochrane review for prolapse surgery in 2008 provided two conclusions: abdominal sacrocolpopexy had lower recurrent vault prolapse rates than sacrospinous colpopexy but this was balanced against a longer time to return to activities of daily life. An additional continence procedure at the time of prolapse surgery might be beneficial in reducing post-operative stress urinary incontinence; however, this was weighed against potential adverse effects. The aim of this review is to provide an updated summary version of the current Cochrane review on the surgical management of pelvic organ prolapse.

Methods

We searched the Cochrane Incontinence Group Specialised Register and reference lists of randomised or quasi-randomised controlled trials on surgery for pelvic organ prolapse. Trials were assessed independently by two reviewers.

Results

We identified 40 trials including 18 new and three updates. There were no additional studies on surgery for posterior prolapse. Native tissue anterior repair was associated with more anterior compartment failures than polypropylene mesh repair as an overlay (RR 2.14, 95% CI 1.23–3.74) or armed transobturator mesh (RR 3.55, 95% CI 2.29–5.51). There were no differences in subjective outcomes, quality of life data, de novo dyspareunia, stress urinary incontinence, reoperation rates for prolapse or incontinence, although some of these data were limited. Mesh erosions were reported in 10% (30/293). Including new studies on the impact of continence surgery at the time of prolapse surgery, meta-analysis revealed that concurrent continence surgery did not significantly reduce the rate of post-operative stress urinary incontinence (RR 1.39, 95% CI 0.53–3.70; random-effects model).

Conclusion

The inclusion of new randomised controlled trials showed that the use of mesh at the time of anterior vaginal wall repair reduced the risk of recurrent anterior vaginal wall prolapse on examination. However, this was not translated into improved functional or quality of life outcomes. The value of a continence procedure in addition to a prolapse operation in women who are continent pre-operatively remains uncertain. Adequately powered randomised controlled trials are needed and should particularly include women's perceptions of prolapse symptoms and functional outcome.

Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM (2010) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev (4):CD004014

Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S (2008) Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn 27:3–12PubMedCrossRef

Tramer MR, Reynolds DJ, Moore RA, McQuay HJ (1997) Impact of covert duplicate publication on meta-analysis: a case study. BMJ 315:635–640PubMed

Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR (1991) Publication bias in clinical research. Lancet 337:867–872PubMedCrossRef

Baden WF, Walker TA (1972) Genesis of the vaginal profile: a correlated classification of vaginal relaxation. Clin Obstet Gynecol 15:1048–1054PubMedCrossRef

Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef

Ali S, Han HC, Lee LC (2006) A prospective randomized trial using Gynemesh PS (trademark) for the repair of anterior vaginal wall prolapse (Abstract number 292). Int Urogynecol J Pelvic Floor Dysfunct 17(Suppl 2):221

Allahdin S, Glazener C, Bain C (2008) A randomised controlled trial evaluating the use of polyglactin mesh, polydioxanone and polyglactin sutures for pelvic organ prolapse surgery. J Obstet Gynaecol 28:427–431PubMedCrossRef

Al-Nazer MA, Ismail WA, Gomaa IA (2007) Comparative study between anterior colporraphy versus vaginal wall repair with mesh for management of anterior vaginal wall prolapse (Abstract number 84). Int Urogynecol J Pelvic Floor Dysfunct 18(Suppl 1):49–50

10.

Borstad E, Abdelnoor M, Mogimi K, Sandved M, Majida M, Western K et al (2008) Surgery for concomitant pelvic organ prolapse and urinary stress incontinence. A multicenter prospective randomized trial to compare the results of an incontinence procedure performed at the time of prolapse repair or 3 months after. Neurourol Urodyn 27:713

11.

Braun HF, Fernandez M, Dell’Oro A, Gonzalez F, Cuevas R, Rojas I (2007) Prospective randomised study to compare colposacropexy and Mayo McCall technique in the correction of severe genital central prolapse (Abstract number 19). Int Urogynecol J Pelvic Floor Dysfunct 18(Suppl 1):12

12.

Costantini E, Zucchi A, Giannantoni A, Mearini L, Bini V, Porena M (2007) Must colposuspension be associated with sacropexy to prevent postoperative urinary incontinence? Eur Urol 51:788–794PubMedCrossRef

13.

Costantini E, Lazzeri M, Bini V, Del Zingaro M, Zucchi A, Porena M (2008) Burch colposuspension does not provide any additional benefit to pelvic organ prolapse repair in patients with urinary incontinence: a randomized surgical trial. J Urol 180:1007–1012PubMedCrossRef

14.

de Tayrac R, Mathe ML, Bader G, Deffieux X, Fazel A, Fernandez H (2008) Infracoccygeal sacropexy or sacrospinous suspension for uterine or vaginal vault prolapse. Int J Gynaecol Obstet 100:154–159PubMedCrossRef

15.

Dietz V, Schraffordt KS, Van der Graaf Y, Heintz P, Van der Vaart C (2008) Sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study (Abstract number 92). Int Urogynecol J Pelvic Floor Dysfunct 19(Suppl 1):94–96

16.

Guerette NL, Aguirre O, Vandrie DM, Biller DH, Davila GW (2006) Multi-center, randomized, prospective trial comparing anterior colporrhaphy alone to bovine pericardium collagen matrix graft reinforced anterior colporrhaphy: 12-month analysis (Abstract number 11). Int Urogynecol J Pelvic Floor Dysfunct 17(Suppl 2):63–64

17.

Lim JL, Carey MP, Higgs PJ, Goh J, Krause H, Leong A et al (2007) Vaginal colporrhaphy versus vaginal repair with mesh for pelvic organ prolapse: a randomised controlled trial. Int Urogynecol J Pelvic Floor Dysfunct 18(Suppl 1):38–39

18.

Natale F, Mako A, Panei M, Weir J, Antomarchi F, Cervigni M (2007) Prospective randomized controlled study between two different procedures to suspend the vaginal vault: high levator myorrhaphy and uterosacral vaginal vault suspension (Abstract number 6). Neurourol Urodyn 26:608–609

19.

Natale F, La Penna C, Padoa A, Agostini M, De Simone E, Cervigni M (2009) A prospective, randomized, controlled study comparing Gynemesh, a synthetic mesh, and Pelvicol, a biologic graft, in the surgical treatment of recurrent cystocele. Int Urogynecol J Pelvic Floor Dysfunct 20:75–81PubMedCrossRef

20.

Nguyen JN, Burchette RJ (2008) Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 111:891–898PubMedCrossRef

21.

Nieminen K, Hiltunen R, Heiskanen E, Takala T, Niemi K, Merikari M et al (2008) Symptom resolution and sexual function after anterior vaginal wall repair with or without polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 19:1611–1616PubMedCrossRef

22.

Pantazis K, Freeman R, Thomson A, Frappell J, Bombieri L, Waterfield A (2008) Results from the LAS Trial, an RCT comparing open abdominal to laparoscopic sacrocolpopexy for the treatment of post hysterectomy vault prolapse (Abstract number 120). Int Urogynecol J Pelvic Floor Dysfunct 19(Suppl 1):101–102

23.

Schierlitz L, Dwyer P, Rosamilia A, Murray C, Thomas E, Taylor N et al (2007) A prospective randomised controlled study comparing vaginal prolapse repair with and without tension free vaginal tape (TVT) in women with severe pelvic organ prolapse and occult stress incontinence (Abstract number 114). Neurourol Urodyn 26:743–744

24.

Sivaslioglu AA, Unlubilgin E, Dolen I (2008) A randomized comparison of polypropylene mesh surgery with site-specific surgery in the treatment of cystocoele. Int Urogynecol J Pelvic Floor Dysfunct 19:467–471PubMedCrossRef

25.

Brubaker L, Nygaard I, Richter HE, Visco A, Weber AM, Cundiff GW et al (2008) Two-year outcomes after sacrocolpopexy with and without Burch to prevent stress urinary incontinence. Obstet Gynecol 112:49–55PubMedCrossRef

26.

Visco AG, Brubaker L, Nygaard I, Richter HE, Cundiff G, Fine P et al (2008) The role of preoperative urodynamic testing in stress-continent women undergoing sacrocolpopexy: the Colpopexy and Urinary Reduction Efforts (CARE) randomized surgical trial. Int Urogynecol J Pelvic Floor Dysfunct 19:607–614PubMedCrossRef

27.

Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kocjancic E (2007) Porcine skin collagen implants to prevent anterior vaginal wall prolapse recurrence: a multicenter, randomized study. J Urol 177:192–195PubMedCrossRef

28.

Roovers JP, van der Vaart CH, van der Bom JG, van Leeuwen JH, Scholten PC, Heintz AP (2004) A randomised controlled trial comparing abdominal and vaginal prolapse surgery: effects on urogenital function. Bjog 111:50–56PubMedCrossRef

29.

Benson JT, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1421, discussion 1421–2PubMedCrossRef

30.

Culligan PJ, Blackwell L, Goldsmith LJ, Graham CA, Rogers A, Heit MH (2005) A randomized controlled trial comparing fascia lata and synthetic mesh for sacral colpopexy. Obstet Gynecol 106:29–37PubMedCrossRef

31.

Jeng CJ, Yang YC, Tzeng CR, Shen J, Wang LR (2005) Sexual functioning after vaginal hysterectomy or transvaginal sacrospinous uterine suspension for uterine prolapse: a comparison. J Reprod Med 50:669–674PubMed

32.

Lo TS, Wang AC (1998) Abdominal colposacropexy and sacrospinous ligament suspension for severe uterovaginal prolapse: a comparison. J Gynecol Surg 14:59–64CrossRef

33.

Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ (2004) Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol 190:20–26PubMedCrossRef

34.

Meschia M, Gattei U, Pifarotti P, Spennacchio M, Longatti D, Barbacini P. (2004) Randomized comparison between infracoccygeal sacropexy (posterior IVS) and sacrospinous fixation in the management of vault prolapse (abstract 614). Neurourol Urodyn 23:614

35.

Bump RC, Hurt WG, Theofrastous JP, Addison WA, Fantl JA, Wyman JF et al (1996) Randomized prospective comparison of needle colposuspension versus endopelvic fascia plication for potential stress incontinence prophylaxis in women undergoing vaginal reconstruction for stage III or IV pelvic organ prolapse. The Continence Program for Women Research Group. Am J Obstet Gynecol 175:326–333, discussion 333–5PubMedCrossRef

36.

Cervigni M, Natale F, Weir J, Galante L, Panei M, Agostini A et al (2005) Prospective randomized trial of two new materials for the correction of anterior compartment prolapse: Pelvicol and Prolene Soft (Abstract). Neurourol Urodyn 24:585–586

37.

Colombo M, Maggioni A, Scalambrino S, Vitobello D, Milani R (1997) Surgery for genitourinary prolapse and stress incontinence: a randomized trial of posterior pubourethral ligament plication and Pereyra suspension. Am J Obstet Gynecol 176:337–343PubMedCrossRef

38.

Colombo M, Maggioni A, Zanetta G, Vignali M, Milani R (1996) Prevention of postoperative urinary stress incontinence after surgery for genitourinary prolapse. Obstet Gynecol 87:266–271PubMedCrossRef

39.

Colombo M, Vitobello D, Proietti F, Milani R (2000) Randomised comparison of Burch colposuspension versus anterior colporrhaphy in women with stress urinary incontinence and anterior vaginal wall prolapse. Bjog 107:544–551PubMedCrossRef

40.

De Ridder D, Claerhout F, Verleyen P, Boulanger S, Deprest J (2004) Procine dermis xenograft as reinforcement for cystocele stage III repair: a prospective randomized controlled trial (Abstract). Neurourol Urodyn 23:435–436

41.

Gandhi S, Goldberg RP, Kwon C, Koduri S, Beaumont JL, Abramov Y et al (2005) A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse. Am J Obstet Gynecol 192:1649–1654PubMedCrossRef

42.

Meschia M, Pifarotti P, Spennacchio M, Buonaguidi A, Gattei U, Somigliana E (2004) A randomized comparison of tension-free vaginal tape and endopelvic fascia plication in women with genital prolapse and occult stress urinary incontinence. Am J Obstet Gynecol 190:609–613PubMedCrossRef

43.

Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ et al (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1362PubMedCrossRef

44.

Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1304, discussion 1304–6PubMedCrossRef

45.

Nieminen K, Hiltunen K, Laitinen J, Oksala J, Heinonen P (2003) Transanal or vaginal approach to retocele repair: results of a prospective randomised study. Neurourol Urodynam 22:547–548

46.

Nieminen K, Hiltunen KM, Laitinen J, Oksala J, Heinonen PK (2004) Transanal or vaginal approach to rectocele repair: a prospective, randomized pilot study. Dis Colon Rectum 47:1636–1642PubMedCrossRef

47.

Kahn MA, Stanton SL, Kumar D, Fox SD (1999) Posterior colporrhaphy is superior to the transanal repair for treatment of posterior vaginal wall prolapse. Neurourol Urodyn 18:70

48.

Paraiso MF, Barber MD, Muir TW, Walters MD (2006) Rectocele repair: a randomized trial of three surgical techniques including graft augmentation. Am J Obstet Gynecol 195:1762–1771PubMedCrossRef

49.

Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S (2004) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev (3):CD004014

50.

Baessler K, Hewson AD, Tunn R, Schuessler B, Maher CF (2005) Severe mesh complications following intravaginal slingplasty. Obstet Gynecol 106:713–716PubMedCrossRef

Titel: Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review
verfasst von: Christopher M. Maher
Benny Feiner
Kaven Baessler
Cathryn M. A. Glazener
Publikationsdatum: 01.11.2011
Verlag: Springer-Verlag
Erschienen in: International Urogynecology Journal / Ausgabe 11/2011
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-011-1542-9

Neu im Fachgebiet Gynäkologie und Geburtshilfe

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Neu im Fachgebiet Gynäkologie und Geburtshilfe

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Gynäkologie

Springer Medizin

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2011

Guidelines and standardisation documents should be published anonymously

The effect of l-arginine on bladder dysfunction following ovariectomy in a rabbit model

Imaging in urogynaecology

Uterosacral ligament vaginal vault suspension using delayed absorbable monofilament suture

Transvaginal mesh surgery for pelvic organ prolapse—Prolift+M: a prospective clinical trial

The effect of pregnancy and childbirth on pelvic floor muscle function

Neu im Fachgebiet Gynäkologie und Geburtshilfe

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Gynäkologie