Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse
Background/Purpose: The most suitable surgical technique for pelvic organ prolapse (POP) remains undetermined. The aim of this study was to compare clinical outcomes of the tailored transvaginal mesh (TVM) surgery and vaginal native tissue repair (NTR) surgery for POP. Methods: Between November 2011...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-12-01
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| Series: | Journal of the Formosan Medical Association |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664619303389 |
| _version_ | 1818260281495650304 |
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| author | Ting-Chen Chang Sheng-Mou Hsiao Pei-Chi Wu Chi-Hau Chen Wen-Yih Wu Ho-Hsiung Lin |
| author_facet | Ting-Chen Chang Sheng-Mou Hsiao Pei-Chi Wu Chi-Hau Chen Wen-Yih Wu Ho-Hsiung Lin |
| author_sort | Ting-Chen Chang |
| collection | DOAJ |
| description | Background/Purpose: The most suitable surgical technique for pelvic organ prolapse (POP) remains undetermined. The aim of this study was to compare clinical outcomes of the tailored transvaginal mesh (TVM) surgery and vaginal native tissue repair (NTR) surgery for POP. Methods: Between November 2011 and August 2014, medical records of 339 women receiving POP surgeries were reviewed. Results: Compared with the NTR group (n = 169), the use of TVM surgery (n = 170) was a predictor for longer operation time (coefficient = 25.2 min, P < 0.001) and larger blood loss (coefficient = 79.9 mL, P < 0.001) by multivariable analysis. However, a higher recurrence rate of cystoceles (log-rank test, P = 0.001) was found in the NTR group, compared with the TVM group; but not apical prolapse (P = 0.32) or rectocele (P = 0.45). Multivariable analysis revealed that the TVM surgery (hazard ratio = 0.24, 95% confidence interval = 0.09–0.64, P = 0.004) and old age (hazard ratio = 1.07, 95% confidence interval = 1.02–1.11, P = 0.005) were independent predictors for the recurrence of cystoceles. Based on the receiver operating characteristic curve (ROC) analysis, the cut-off age value was 64 years with an ROC area of 0.65.In women with intact uterus (n = 162), the recurrence rate of cystoceles was lower in the TVM group (log-rank test, P = 0.0001), compared with the NTR group. However, there was no between-group difference in the recurrence rate of cystoceles in women with prior or concomitant hysterectomy (n = 177, P = 0.17). Conclusion: In women with intact uterus, the TVM group has a lower recurrence rate of cystoceles than the NTR group. In addition, old age, especially more than 64 years old, is a risk factor for cystocele recurrence. Keywords: Cystocele, Pelvic organ prolapse, Surgical mesh |
| first_indexed | 2024-12-12T18:28:50Z |
| format | Article |
| id | doaj.art-25e66aadf64c4816b13a3bf77334b033 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-12T18:28:50Z |
| publishDate | 2019-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-25e66aadf64c4816b13a3bf77334b0332022-12-22T00:15:58ZengElsevierJournal of the Formosan Medical Association0929-66462019-12-011181216231632Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapseTing-Chen Chang0Sheng-Mou Hsiao1Pei-Chi Wu2Chi-Hau Chen3Wen-Yih Wu4Ho-Hsiung Lin5Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanDepartment of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, TaiwanDepartment of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanDepartment of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, TaiwanDepartment of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Corresponding author. Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, No. 8, Chung-Shan South Road, Taipei, 100, Taiwan. Fax: +886 2 23123456x71557.Background/Purpose: The most suitable surgical technique for pelvic organ prolapse (POP) remains undetermined. The aim of this study was to compare clinical outcomes of the tailored transvaginal mesh (TVM) surgery and vaginal native tissue repair (NTR) surgery for POP. Methods: Between November 2011 and August 2014, medical records of 339 women receiving POP surgeries were reviewed. Results: Compared with the NTR group (n = 169), the use of TVM surgery (n = 170) was a predictor for longer operation time (coefficient = 25.2 min, P < 0.001) and larger blood loss (coefficient = 79.9 mL, P < 0.001) by multivariable analysis. However, a higher recurrence rate of cystoceles (log-rank test, P = 0.001) was found in the NTR group, compared with the TVM group; but not apical prolapse (P = 0.32) or rectocele (P = 0.45). Multivariable analysis revealed that the TVM surgery (hazard ratio = 0.24, 95% confidence interval = 0.09–0.64, P = 0.004) and old age (hazard ratio = 1.07, 95% confidence interval = 1.02–1.11, P = 0.005) were independent predictors for the recurrence of cystoceles. Based on the receiver operating characteristic curve (ROC) analysis, the cut-off age value was 64 years with an ROC area of 0.65.In women with intact uterus (n = 162), the recurrence rate of cystoceles was lower in the TVM group (log-rank test, P = 0.0001), compared with the NTR group. However, there was no between-group difference in the recurrence rate of cystoceles in women with prior or concomitant hysterectomy (n = 177, P = 0.17). Conclusion: In women with intact uterus, the TVM group has a lower recurrence rate of cystoceles than the NTR group. In addition, old age, especially more than 64 years old, is a risk factor for cystocele recurrence. Keywords: Cystocele, Pelvic organ prolapse, Surgical meshhttp://www.sciencedirect.com/science/article/pii/S0929664619303389 |
| spellingShingle | Ting-Chen Chang Sheng-Mou Hsiao Pei-Chi Wu Chi-Hau Chen Wen-Yih Wu Ho-Hsiung Lin Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse Journal of the Formosan Medical Association |
| title | Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse |
| title_full | Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse |
| title_fullStr | Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse |
| title_full_unstemmed | Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse |
| title_short | Comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse |
| title_sort | comparison of clinical outcomes between tailored transvaginal mesh surgery and native tissue repair for pelvic organ prolapse |
| url | http://www.sciencedirect.com/science/article/pii/S0929664619303389 |
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