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Absorbable mesh augmentation compared with no mesh for anterior prolapse: a randomized controlled trial.
Magali Robert1, Isabelle Girard, Erin Brennand
1Departments of Obstetrics and Gynecology, University of Calgary, Calgary, and University of Edmonton, Edmonton, Alberta, and University of Sherbrooke, Sherbrooke, Quebec, Canada.
Obstetrics and Gynecology
|January 10, 2014
Summary
For anterior pelvic organ prolapse (POP) surgery, using porcine small intestine submucosa mesh showed no significant difference in anatomical or patient-reported outcomes compared to native tissue repair. The mesh did not provide additional benefit in this study.
Area of Science:
- Urogynecology
- Pelvic Floor Disorders
- Surgical Innovation
Background:
- Anterior compartment pelvic organ prolapse (POP) affects many women.
- Surgical repair options include native tissue repair and mesh augmentation.
- Porcine small intestine submucosa mesh is one type of augmentation material.
Purpose of the Study:
- To compare anatomical and patient-reported outcomes 12 months after anterior POP surgery.
- To evaluate the efficacy of porcine small intestine submucosa mesh augmentation versus native tissue repair.
Main Methods:
- Randomized controlled trial with 12-month follow-up.
- Surgical procedures were identical except for mesh placement.
- Primary outcome: anatomical cure using Pelvic Organ Prolapse Quantification (POP-Q).
- Secondary outcomes: POP-Q stage, patient-reported outcomes, patient satisfaction.
Main Results:
- 57 women were randomized (28 mesh, 29 no mesh).
- Anatomical cure rates were similar: 56% (mesh) vs. 61% (no mesh).
- No significant differences in recurrent prolapse or patient-reported outcomes were observed between groups.
Conclusions:
- Porcine small intestine submucosa mesh did not offer additional benefit over native tissue repair for anterior POP.
- Both surgical approaches yielded comparable anatomical and patient-reported outcomes at 12 months.
