Pelvic Organ Prolapse Clinical Trial
Official title:
Prospective Randomized Study to Compare Anatomical, Functional and Sexual Results of Pelvic Organ Prolapse Repair With One Versus Two Vaginal Meshes While Preserving the Uterus
The purpose of this study is to compare anatomical differences, quality of life and sexual function and complications rate between apical support with one anterior vaginal mesh versus repair with two separate meshes.
In the presence of stage 3 anterior wall prolapse (cystocele) with second stage apical
prolapse (uterine or vault prolapse) there are 2 optional ways to repair with vaginal mesh:
(a) to use 2 separated meshes: anterior mesh to correct the anterior compartment and
posterior mesh to correct the apical prolapse to the sacrospinous ligament (SSL). (b) To
correct both anterior compartment and the apical prolapse with the same mesh while using the
posterior arms of the mesh to fix the apical prolapse to the SSL. Each way has its
advantages and disadvantages. The first way was described at the beginning of mesh use and
might be more anatomical then the second newest way. The addition of apical support to the
anterior mesh might theoretically shorten the vagina. There are several recent studies
describing the anatomical outcomes both for anterior compartment and apical compartment with
a single mesh. Mesh-related complications, which can be also related to the amount of
vaginal meshes, can potentially decrease with one mesh as compare with 2 meshes.
The aim of the study:
If the anatomical results, vaginal length and quality of life, will be with no significant
differences between the two groups, the investigators will recommend to use a single mesh,
in order to avoid / minimize potential complications of vaginal mesh.
If there will be no differences in complications in both groups but will be a significant
difference in vaginal length and sexual function, the investigators will recommend using two
meshes.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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