Uterine Prolapse Clinical Trial
Official title:
A Prospective, Multicenter Trial to Compare GYNECARE PROSIMA* Pelvic Floor Repair System Procedure With Modified Total Pelvic Floor Reconstruction Surgery Concomitantly With TVH to Treat Symptomatic POP-Q Stage III Uterine Prolapse
Pelvic Organ prolapse (a feeling of bulge in the vagina) may cause some distressing symptoms
such as loss of control of the bowel or bladder, and may also cause problems with patient's
sex life. The primary treatment is surgery, sometimes a mesh is placed in the pelvis to
support the weakened tissues, but mesh implants can cause complications.
This study is designed to determine the effectiveness and safety of GYNECARE PROSIMA* pelvic
floor repair system compared with the modified total pelvic floor reconstructive surgery
with mesh for the treatment of uterine prolapse.
Patients enrolled into the study will be followed up for up to 3 years after surgery.
Evaluation will take place during surgery and postoperative visit. Stage of prolapse before
and after surgery, patient satisfaction through quality of life and sexual function
questionnaires before and after surgery, and peri-operative complication rates will be
evaluated.
Pelvic organ prolapse is a common problem. The high rate of failure has led to an increasing
use of synthetic grafts to augment vaginal repair procedures to obtain more durable results.
In 2005, the investigators began to perform modified pelvic floor reconstruction surgery
with mesh. The nation-wide multicenter prospective clinical trial data showed that it was
safe, efficient and cost-effective. No severe intraoperative complications were recorded and
the recurrence rate after 1 year follow-up was 8.1%. Quality of life improved significantly
from the baseline, while the sexual function did not change.
The GYNECARE PROSIMA* system is a new technique. It provides a simplified unanchored mesh
repair, avoiding the need for dissection outside the pelvic cavity and avoids passage of
suture and instruments through the obturator foramen and sacrospinous ligament, thus making
surgery much simpler to perform and reduces the risk of the specific complications that can
occur with suture placement or tunneling. 1-year anatomic and functional outcomes of
international multicenter prospective study for POP-Q Stage I I-III pelvic organ prolapse
showed the objective success rate was 76.9%, pelvic symptoms, quality of life, and sexual
function improved significantly from baseline.
In clinical practice, many women have symptomatic POP-Q Stage III uterine prolapse, which
requires surgical correction. They are relatively young, and therefore care more about the
long-term outcomes and quality of life after procedure. The purpose of this multicenter,
prospective, and comparative study is to evaluate the effectiveness and safety of these two
procedures concomitantly performed with vaginal hysterectomy (TVH) in the treatment of
symptomatic POP-Q Stage III uterine prolapse in China.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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