Document Detail


Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles.
MedLine Citation:
PMID:  11408853     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our aim was to evaluate the efficacy of polyglactin 910 mesh in preventing recurrent cystoceles and rectoceles. STUDY DESIGN: In a prospective, randomized, controlled trial, patients undergoing vaginal reconstructive surgery with cystoceles to the hymenal ring and beyond were randomly selected to undergo anterior and posterior colporrhaphy with or without polyglactin 910 mesh reinforcement. Results were evaluated preoperatively and at 2, 6, 12, and 52 weeks postoperatively. RESULTS: A total of 161 women were randomly selected for this study. One woman was excluded at the time of surgery, and 17 women were lost to follow-up. Eighty women received mesh, and 80 did not. Both groups were found to be equivalent with respect to age, parity, concomitant surgery, and menopausal and hormone replacement status. Preoperatively 49 women had a central cystocele to the hymenal ring and 111 women had cystoceles beyond the introitus; 91 women had a rectocele to the mid-vaginal plane, 31 to the hymenal ring, and 22 beyond the introitus. After 1 year, 30 (43%) of 70 subjects without mesh and 18 (25%) of 73 subjects with mesh had recurrent cystoceles beyond the mid-vaginal plane (P =.02). Eight women without mesh and 2 women with mesh had recurrent cystoceles to the hymenal ring (P =.04). No recurrent cystoceles beyond the hymenal ring occurred in either group. Multivariate logistic regression analysis showed concurrent slings to be associated with significantly fewer recurrent cystoceles (odds ratio, 0.32; P =.005), whereas the presence of mesh remained significantly predictive of fewer cystocele recurrences in this analysis. Thirteen recurrent rectoceles were noted 1 year postoperatively, with no differences between groups. CONCLUSION: Polyglactin 910 mesh was found to be useful in the prevention of recurrent cystoceles.
Authors:
P K Sand; S Koduri; R W Lobel; H A Winkler; J Tomezsko; P J Culligan; R Goldberg
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  184     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-06-15     Completed Date:  2001-07-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1357-62; discussion 1362-4     Citation Subset:  AIM; IM    
Affiliation:
Evanston Continence Center, Division of Urogynecology, Evanston Northwestern Healthcare, Northwestern University Medical School, Illinois 60201, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Humans
Incidence
Middle Aged
Polyglactin 910*
Prospective Studies
Rectocele / epidemiology,  prevention & control*,  surgery*
Recurrence / prevention & control
Surgical Mesh*
Treatment Outcome
Urinary Bladder Diseases / epidemiology,  prevention & control*,  surgery*
Chemical
Reg. No./Substance:
34346-01-5/Polyglactin 910
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2002 Apr;186(4):852; author reply 852-3   [PMID:  11967523 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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