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Randomized Trial of Fascia Lata and Polypropylene Mesh for Abdominal Sacrocolpopexy: 5-year Follow-up

Overview
Journal Int Urogynecol J
Publisher Springer
Specialties Gynecology & Obstetrics
Urology
Date 2010 Aug 28
PMID 20798922
Citations 24
Authors
Susan B Tate
Linda Blackwell
Douglas J Lorenz
Margaret M Steptoe
Patrick J Culligan
Affiliations
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Abstract

Introduction And Hypothesis: The purpose of this study is to evaluate the 5-year surgical outcomes of abdominal sacrocolpopexy among subjects randomized to receive polypropylene mesh or cadaveric fascia lata.

Methods: All 100 subjects from the original randomized clinical trial were eligible. Primary outcome was objective anatomic failure: any pelvic organ prolapse quantification (POP-Q) point ≥ - 1. Secondary outcome was clinical failure-presence of bulge or prolapse symptoms and either a POP-Q point C ≥ ½ TVL or any POP-Q point >0-and interim surgical re-treatment. Wilcoxon tests and Fisher's exact test were performed.

Results: Fifty-eight subjects returned for 5-year follow-up-29 mesh and 29 fascia. Objective anatomic success rates were: mesh, 93% (27/29) and fascia, 62% (18/29) (p = 0.02). Clinical success rates were: mesh, 97% (28/29) and fascia, 90% (26/29) (p = 0.61).

Conclusions: Polypropylene mesh was superior to cadaveric fascia lata using objective anatomic outcomes. Success rates of mesh and fascia were comparable using a clinical definition that combined symptoms with anatomic measures.

Citing Articles

Sacrocolpopexy: Alternatives to Mesh Grafts.

Yong C, Raoofi M, Carey M Int Urogynecol J. 2024; 36(1):3-10.

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Outcomes of Abdominal Apical Suspension Using Mesh in a Tertiary Training Hospital: A Seven-year Retrospective Review.

Cadiz M, Aguinaldo J Acta Med Philipp. 2024; 58(11):46-53.

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Narrative review of flaps and grafts in robotic reconstructive urologic surgery.

Doersch K, Hines L, Ajay D Ann Laparosc Endosc Surg. 2024; 9.

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Surgery for women with apical vaginal prolapse.

Maher C, Yeung E, Haya N, Christmann-Schmid C, Mowat A, Chen Z Cochrane Database Syst Rev. 2023; 7:CD012376.

PMID: 37493538 PMC: 10370901. DOI: 10.1002/14651858.CD012376.pub2.

Robotic Sacrocolpopexy with Autologous Fascia Lata: A Case Series.

Damiani G, Villa M, Falcicchio G, Cesana C, Malvasi A, Picardi N Gynecol Minim Invasive Ther. 2023; 12(1):10-14.

PMID: 37025435 PMC: 10071871. DOI: 10.4103/gmit.gmit_7_22.

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