Preoperative predictors and a prediction score for perception of improvement after mesh prolapse surgery
In: ISSN: 0937-3462, 2019
academicJournal
Zugriff:
International audience ; Introduction and hypothesis: Pelvic organ prolapse (POP) surgery using a mesh has a complication rate of 26%, and an estimated 10% of those operated on do not consider it brings improvement. The objective of this study was to identify preoperative predictors of improvement after POP repair with mesh to develop a predictive score. Methods: This is a secondary analysis of the randomized multicenter trial PROSPERE, which compared morbidity after prolapse repair with mesh according to the vaginal or laparoscopic approach. Improved women [PGI-I score at 1-year follow-up = 1 (much better) or 2 (better)] were compared with unimproved women. Two hundred fifty-five women were included to derive the prediction score based on multiple logistic regression. An internal validation by bootstrapping estimated the unbiased performance of the model. Results: Criteria independently related to improvement were: (1) cystocele stage > II [OR: 2.93 95% CI (1.22–7.04), p = 0.015]; (2) preoperative expectation related to bulge symptom improvement [OR: 2.57 95% CI (1.07–6.04), p = 0.031] and (3) absence of chronic pelvic pain [OR: 4.55 95% CI (1.77–11.46), p = 0.001]. A score (scored from 0 to 11) was constructed from the aOR of the predictive model: the ROC-AUC of the score was 0.75, and a score ≥ 9 predicted a 97% chance of improvement (95% CI 92–99), with a specificity of 85% (95% CI 68–94). The ROC-AUC corrected for optimism by the bootstrap procedure was 0.70. Conclusions: This score could be used by surgeons in preoperative counseling of women.
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Preoperative predictors and a prediction score for perception of improvement after mesh prolapse surgery
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Autor/in / Beteiligte Person: | Chattot, Chloé ; Deffieux, Xavier ; Lucot, Jean Philippe ; Fritel, Xavier ; Fauconnier, Arnaud ; Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ) ; Service de gynécologie et obstétrique CHI Poissy-Saint Germain ; Poissy-Saint-Germain, CHI ; Service de gynécologie-obstétrique, médecine de la reproduction Béclère ; Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère Clamart ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) ; Hôpital Jeanne de Flandre Lille ; Service de gynécologie, obstétrique, médecine et biologie de la reproduction CHU Poitiers = Department of Gynecology, Obstetrics, Reproductive Medicine and Biology Poitiers University Hospital ; Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ) |
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Zeitschrift: | ISSN: 0937-3462, 2019 |
Veröffentlichung: | HAL CCSD ; Springer Verlag, 2019 |
Medientyp: | academicJournal |
DOI: | 10.1007/s00192-019-03953-6 |
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