A Randomized Controlled Trial Comparing Fascia Lata and Synthetic Mesh for Sacral Colpopexy
- 1 July 2005
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 106 (1), 29-37
- https://doi.org/10.1097/01.aog.0000165824.62167.c1
Abstract
To compare the objective anatomic outcomes after sacral colpopexy performed with cadaveric fascia lata and polypropylene mesh. 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. 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). Polypropylene mesh was superior to fascia lata in terms of POP-Q points, POP-Q stage, and objective anatomic failure rates. I.Keywords
This publication has 18 references indexed in Scilit:
- Abdominal Sacrocolpopexy: A Comprehensive ReviewObstetrics & Gynecology, 2004
- Procedures for pelvic organ prolapse in the United States, 1979-1997American Journal of Obstetrics and Gynecology, 2003
- Long-term success of abdominal sacral colpopexy using synthetic meshAmerican Journal of Obstetrics and Gynecology, 2002
- The demographics of pelvic floor disorders: Current observations and future projectionsAmerican Journal of Obstetrics and Gynecology, 2001
- The Standardization of Terminology for Researchers in Female Pelvic Floor DisordersInternational Urogynecology Journal, 2001
- Total pelvic mesh repairDiseases of the Colon & Rectum, 2001
- The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of deliveryBJOG: An International Journal of Obstetrics and Gynaecology, 2000
- The fate of rectus fascia suburethral slingsAmerican Journal of Obstetrics and Gynecology, 2000
- Functional failure of fascia lata allograftsAmerican Journal of Obstetrics and Gynecology, 1999
- The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunctionAmerican Journal of Obstetrics and Gynecology, 1996