Document Detail


A randomized controlled trial comparing fascia lata and synthetic mesh for sacral colpopexy.
MedLine Citation:
PMID:  15994614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the objective anatomic outcomes after sacral colpopexy performed with cadaveric fascia lata and polypropylene mesh. METHODS: Patients undergoing a sacral colpopexy were randomized to receive either fascia lata or polypropylene mesh in a double-blinded fashion. Data were collected at 6 weeks, 3 months, 6 months, and 1 year postoperatively. The main outcome measures were pelvic organ prolapse quantification (POP-Q) system stage and individual POP-Q points over time. Objective anatomic failure was defined as POP-Q stage 2 or more at any point during the follow-up period. Proportions of patients with objective anatomic failure at 1 year in each group were compared using the chi(2) test. Mean POP-Q points and stage at 1 year were compared by using the independent samples t test. RESULTS: One hundred patients were randomized to receive either fascia (n = 46) or mesh (n = 54). Of the 89 patients returning for 1-year follow-up, 91% (41/45) of the mesh group and 68% (30/44) of the fascia group were classified as objectively cured (P = .007). We found significant differences between the mesh and fascia groups with respect to the 1-year postoperative comparisons of points Aa, C, and POP-Q stage. There were no differences between the 2 groups with respect to points TVL (total vaginal length), GH (genital hiatus), PB (perineal body), Ap or Bp (2 points along the posterior vaginal wall). CONCLUSIONS: Polypropylene mesh was superior to fascia lata in terms of POP-Q points, POP-Q stage, and objective anatomic failure rates. LEVEL OF EVIDENCE: I.
Authors:
Patrick J Culligan; Linda Blackwell; Linda J Goldsmith; Carol A Graham; Aimee Rogers; Michael H Heit
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  106     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-08-11     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29-37     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Gynecology and Women's Health, Division of Urogynecology and Reconstructive Pelvic Surgery, University of Louisville Health Sciences Center, Kentucky, USA. patrick.culligan@ahsys.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Colposcopy / methods*
Double-Blind Method
Fascia Lata / transplantation*
Female
Follow-Up Studies
Gynecologic Surgical Procedures / methods*
Humans
Middle Aged
Patient Satisfaction
Polypropylenes*
Probability
Reference Values
Risk Assessment
Severity of Illness Index
Surgical Mesh*
Treatment Outcome
Ultrasonography, Doppler
Uterine Prolapse / surgery*,  ultrasonography
Chemical
Reg. No./Substance:
0/Polypropylenes

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


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