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The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair : a randomized controlled trial . INTRODUCTION AND HYPOTHESIS The aim of the study was to compare the efficacy and safety of transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy for treatment of anterior vaginal wall prolapse . METHODS This is a randomized controlled trial in which women with advanced anterior vaginal wall prolapse , at least stage II with Ba ≥ +1 cm according to the Pelvic Organ Prolapse Quantification ( POP-Q ) classification , were randomly assigned to have either anterior colporrhaphy ( n = 39 ) or repair using trocar-guided transvaginal mesh ( n = 40 ) . The primary outcome was objective cure rate of the anterior compartment ( point Ba ) assessed at the 12-month follow-up visit , with stages 0 and I defined as anatomical success . Secondary outcomes included quantification of other vaginal compartments ( POP-Q points ) , comparison of quality of life by the prolapse quality of life ( P-QOL ) questionnaire , and complication rate between the groups after 1 year . Study power was fixed as 80 % with 5 % cutoff point ( p < 0.05 ) for statistical significance . RESULTS The groups were similar regarding demographic and clinical preoperative parameters . Anatomical success rates for colporrhaphy and repair with mesh placement groups were 56.4 vs 82.5 % ( 95 % confidence interval 0.068-0.54 ) , respectively , and the difference between the groups was statistically significant ( p = 0.018 ) . Similar total complication rates were observed in both groups , with tape exposure observed in 5 % of the patients . There was a significant improvement in all P-QOL domains as a result of both procedures ( p < 0.001 ) , but they were not distinct between groups ( p > 0.05 ) . CONCLUSIONS Trocar-guided transvaginal synthetic mesh for advanced anterior POP repair is associated with a higher anatomical success rate for the anterior compartment compared with traditional colporrhaphy . Quality of life equally improved after both techniques . However , the trial failed to detect differences in P-QOL scores and complication rates between the groups .
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Intervention_Surgical
transvaginal synthetic mesh
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Intervention_Surgical
transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy
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Outcome_Other
efficacy and safety
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Participant_Condition
anterior vaginal wall prolapse
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Participant_Condition
anterior vaginal wall prolapse .
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Participant_Sex
women
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Participant_Condition
advanced anterior vaginal wall prolapse , at least stage II with Ba ≥ +1 cm according to the Pelvic Organ Prolapse Quantification ( POP-Q ) classification