Comparison of single- versus multicenter outcomes for pelvic organ prolapse repair using a mesh-capturing device.
In: International urogynecology journal, Jg. 29 (2018), Heft 1, S. 91-97
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Zugriff:
Introduction and Hypothesis: The aim of this study was to compare the results of pelvic organ prolapse repair using a capturing device-guided transvaginal mesh in a single- vs multicenter setting.
Methods: One hundred and twelve women operated by two surgeons at one center (2-year follow-up) were compared with 207 women operated on by 26 surgeons at 24 centers (1-year follow-up). Patients were screened at baseline for apical (uterine or vaginal vault) prolapse stage II with or without concomitant anterior vaginal wall prolapse ≥ stage 2 according to the pelvic organ prolapse quantification (POP-Q) system. Outcome measurements included POP-Q evaluations, prolapse-specific symptom questionnaires, and surgical data.
Results: At the end of follow-up 95 out of 98 (96.9%) had an optimal anatomical outcome at the apical segment (POP-Q stage 0-1) in the single center compared with 154 out of 164 (93.9%) in the multicenter study (P = 0.03). There were no serious complications in the single-center study compared with 9 out of 207 (4.3%) in the multicenter study. In patients undergoing surgery for recurrence, the risk ratio for complications overall was 4:1 in favor of the single-center study. There were no significant differences between the studies in any subjective symptom scale.
Conclusions: Compared with multicenter use, large volumes at a single site only resulted in minor improvements of anatomical outcomes and no significant differences with regard to patient-reported outcomes on pelvic organ function or related quality of life. Instead, the greatest benefit of single-center use was the significantly decreased complication rates.
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Comparison of single- versus multicenter outcomes for pelvic organ prolapse repair using a mesh-capturing device.
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Autor/in / Beteiligte Person: | Morcos, E ; Altman, D ; Hunde, D ; Falconer, C |
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Zeitschrift: | International urogynecology journal, Jg. 29 (2018), Heft 1, S. 91-97 |
Veröffentlichung: | London : Springer, 2018 |
Medientyp: | academicJournal |
ISSN: | 1433-3023 (electronic) |
DOI: | 10.1007/s00192-017-3364-x |
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