Fewer Failures With Vaginal Mesh Repair in Prolapse With Avulsion
(HealthDay News) — For women with vaginal prolapse after hysterectomy and levator ani avulsion, Prolift Total is associated with a lower anatomical failure rate than unilateral vaginal sacrospinous colpopexy with native tissue vaginal repair (sacrospinous fixation [SSF]), according to a study published online March 11 in Ultrasound in Obstetrics & Gynecology.
Kamil Svabik, MD, from Charles University in Prague, and colleagues compared the efficacy of standard surgical procedures for post-hysterectomy vaginal vault prolapse in 70 women with levator ani avulsion. Participants were randomized to Prolift Total (36 women) or to SSF (34 women), during the period from 2008–2011.
The researchers found that, at one-year clinical follow-up, anatomical failure was 3% in the Prolift group and 65% in the SSF group (P<0.001). The rates were similar using ultrasound criteria (2.8 vs. 61.8%; P<0.001). The subjective outcome based on the postoperative Pelvic Organ Prolapse Distress Inventory was not significantly different between the groups (15.3 in the Prolift group vs. 21.7 in the SSF group; P=0.16).
"In patients with prolapse after hysterectomy and levator ani avulsion injury, SSF has a higher anatomical failure rate than does the Prolift Total procedure at one-year follow-up," the authors write.
One author disclosed financial ties to medical device companies, including Gynecare, which manufactures the Prolift Total.