Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial.
OBJECTIVE
To compare vaginal repair augmented by mesh with traditional colporrhaphy for the treatment of pelvic organ prolapse.


METHODS
Prospective randomised controlled trial.


METHODS
Tertiary teaching hospital.


METHODS
One hundred and thirty-nine women with stage >or=2 prolapse according to the pelvic organ prolapse quantification (POP-Q) system requiring both anterior and posterior compartment repair.


METHODS
Subjects were randomised to anterior and posterior vaginal repair with mesh augmentation (mesh group, n = 69) or traditional anterior and posterior colporrhaphy (no mesh group, n = 70).


METHODS
The primary outcome was the absence of POP-Q stage >or=2 prolapse at 12 months. Secondary outcomes were symptoms, quality-of-life outcomes and satisfaction with surgery. Complications were also reported.


RESULTS
For subjects attending the 12-month review, success in the mesh group was 81.0% (51 of 63 subjects) compared with 65.6% (40/61) in the no mesh group and was not significantly different (P-value = 0.07). A high level of satisfaction with surgery and improvements in symptoms and quality-of-life data were observed at 12 months compared to baseline in both groups, but there was no significant difference in these outcomes between the two groups. Vaginal mesh exposure occurred in four women in the mesh group (5.6%). De novo dyspareunia was reported by five of 30 (16.7%) sexually active women in the mesh group and five of 33 (15.2%) in the no mesh group at 12 months.


CONCLUSIONS
In this study, vaginal surgery augmented by mesh did not result in significantly less recurrent prolapse than traditional colporrhaphy 12 months following surgery.
Carey
M
M
Department of Urogynaecology, Royal Women's Hospital, Melbourne, Vic., Australia. marcus.carey@thewomens.org.au
Higgs
P
P
Goh
J
J
Lim
J
J
Leong
A
A
Krause
H
H
Cornish
A
A
D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012008:Recurrence; D053825:Suburethral Slings; D013526:Surgical Mesh; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*