title: A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse.
abstract: OBJECTIVE
  The objective of the study was to compare recurrence and complication rates for sacrospinous fixation (SSF) and prolene mesh techniques for the primary treatment of posthysterectomy vaginal vault prolapse.
  
  
  METHODS
  Patients undergoing surgery for vault prolapse were included in a multicenter, randomized, controlled study comparing SSF or total mesh (Prolift; Gynecare/Ethicon, Somerville, NJ). The examination included pelvic organ prolapse quantification, urodynamics, ultrasound, and quality-of-life (QoL) questionnaires before and 3 and 12 months after surgery.
  
  
  RESULTS
  Of 168 randomized patients, 83 underwent SSF and 85 mesh repair. Prolapse recurrence after 12 months occurred in 39.4% of the SSF group and in 16.9% of the mesh group (P = .003). The mesh exposure rate was 20.8%. No difference in QoL improvement as well as of de novo stress urinary incontinence and overactive bladder onset was found.
  
  
  CONCLUSIONS
  Mesh exposure occurrence was balanced against a lower prolapse recurrence rate in the patients undergoing mesh surgery compared with those undergoing SSF.
authors.affiliation: Department of Obstetrics and Gynecology, First Medical Faculty of Charles University in Prague, Prague, Czech Republic. michael.halaska@lf1.cuni.cz
authors.forename: Michael
authors.initials: M
authors.lastname: Halaska
authors.forename: Katerina
authors.initials: K
authors.lastname: Maxova
authors.forename: Oldrich
authors.initials: O
authors.lastname: Sottner
authors.forename: Kamil
authors.initials: K
authors.lastname: Svabik
authors.forename: Michal
authors.initials: M
authors.lastname: Mlcoch
authors.forename: Dusan
authors.initials: D
authors.lastname: Kolarik
authors.forename: Ivana
authors.initials: I
authors.lastname: Mala
authors.forename: Ladislav
authors.initials: L
authors.lastname: Krofta
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Halaska
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000209:etiology / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery; D014621:Vagina / Q000601:surgery*