Comparison of single- versus multicenter outcomes for pelvic organ prolapse repair using a mesh-capturing device.

Abstract:

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.

journal_name

Int Urogynecol J

authors

Morcos E,Altman D,Hunde D,Falconer C,Nordic TVM group.

doi

10.1007/s00192-017-3364-x

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

91-97

issue

1

eissn

0937-3462

issn

1433-3023

pii

10.1007/s00192-017-3364-x

journal_volume

29

pub_type

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