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Surgical Correction of Pelvic Organ Prolapse

Primary Purpose

Pelvic Organ Prolapse

Status
Completed
Phase
Phase 3
Locations
Italy
Study Type
Interventional
Intervention
Colposacropexy
Colposacropexy
Sponsored by
University Of Perugia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pelvic Organ Prolapse focused on measuring pelvic organ prolapse, colposacropexy, surgery

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Study inclusion criteria were POP > 2, age ≥ 18 and ≤ 75 yrs.

Exclusion Criteria:

  • Malignant uterus lesion (leiomyoma, fibromyoma, cervical or endometrial carcinoma)

    • Active pelvic inflammatory disease,
    • Known hypersensitivity to synthetic materials (polypropylene or polyglycolic acid)
    • Pregnancy or lactation
    • Evidence of clinically significant cardiovascular, renal, hepatic or respiratory diseases; and
    • Any condition that in the judgment of the investigators would interfere with the subject's ability to provide informed consent, comply with study instructions, place the subject at increased risk, or which might confound interpretation of study results.

Sites / Locations

  • Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Prolapse repair by open approach

Prolapse repair by laparoscopic approach

Arm Description

Correction of urogenital prolapse by open surgery approach

Correction of urogenital prolapse by laparoscopic approach

Outcomes

Primary Outcome Measures

Operative morbidity and adverse events
Operative morbidity according to Clavien-Dindo classification, measure of perioperative pain with Visual Analogue Score VAS, post-operative adverse events constitute the outcome measures, together with operating time, intra-operative blood loss and length of hospital stay.

Secondary Outcome Measures

Subjective and objective success rate, Patient satisfaction
Success rate: subjective success is absence of symptoms related to prolapse or incontinence using Urogenital Distress Inventory (URI-6) and Impact Incontinence Quality of Life (IIQ-7). Patient satisfaction is defined by replies to the questions of whether the patient is satisfied and would repeat the operation. Objective success is defined as no vaginal prolapse greater or equal to grade 2 at any vaginal site, while the patient performed Valsalva's manouever.

Full Information

First Posted
August 12, 2010
Last Updated
May 19, 2014
Sponsor
University Of Perugia
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1. Study Identification

Unique Protocol Identification Number
NCT01182090
Brief Title
Surgical Correction of Pelvic Organ Prolapse
Official Title
OPEN SURGERY VS LAPAROSCOPY IN SURGERY OF PELVIC ORGAN PROLAPSE
Study Type
Interventional

2. Study Status

Record Verification Date
July 2010
Overall Recruitment Status
Completed
Study Start Date
August 2010 (undefined)
Primary Completion Date
September 2012 (Actual)
Study Completion Date
September 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Of Perugia

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Objective: This prospective randomized trial evaluated outcomes of colposacropexy performed either by open or by conventional laparoscopic approach as therapy for uterovaginal prolapse. Surgical techniques, efficacy and overall results are compared. Methods: In this prospective study 40 consecutive patients with uro-genital prolapse are randomized to sacropexy: 20 by an open approach, 20 by a conventional laparoscopy approach. Anchorage is achieved in both groups by two polypropylene meshes. Check-ups were scheduled at 3, 6, 12 months and then yearly. Pre-operative patient characteristics, operative and post-operative events and follow-up results are recorded.
Detailed Description
Surgical technique In both open or laparoscopic approach the anterior vaginal wall is dissected from the bladder to expose a vaginal wall area of at least 3 x 5 cms where the mesh will be attached with four-five Polyglycolic 0 sutures. The procedure is repeated for the posterior vaginal wall, where the mesh will be attached with three-four Polyglycolic 0 sutures. The sacral promontory surface is prepared and 1 or 2 non-reabsorbable 0.0 sutures are placed into the sacral periosteum about 2 cm below the promontory. A sub-peritoneal tunnel is created through which meshes are passed avoiding traction to the sacrum. The peritoneum is closed over the meshes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pelvic Organ Prolapse
Keywords
pelvic organ prolapse, colposacropexy, surgery

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Prolapse repair by open approach
Arm Type
Active Comparator
Arm Description
Correction of urogenital prolapse by open surgery approach
Arm Title
Prolapse repair by laparoscopic approach
Arm Type
Active Comparator
Arm Description
Correction of urogenital prolapse by laparoscopic approach
Intervention Type
Procedure
Intervention Name(s)
Colposacropexy
Intervention Description
In open approach the anterior vaginal wall is dissected from the bladder to expose a vaginal wall area of at least 3 x 5 cms where the mesh will be attached with four-five Polyglycolic 0 sutures. The procedure is repeated for the posterior vaginal wall, where the mesh will be attached with three-four Polyglycolic 0 sutures. The sacral promontory surface is prepared and 1 or 2 non-reabsorbable 0.0 sutures are placed into the sacral periosteum about 2 cm below the promontory. A sub-peritoneal tunnel is created through which meshes are passed avoiding traction to the sacrum. The peritoneum is closed over the meshes.
Intervention Type
Procedure
Intervention Name(s)
Colposacropexy
Intervention Description
In laparoscopic approach the anterior vaginal wall is dissected from the bladder to expose a vaginal wall area of at least 3 x 5 cms where the mesh will be attached with four-five Polyglycolic 0 sutures. The procedure is repeated for the posterior vaginal wall, where the mesh will be attached with three-four Polyglycolic 0 sutures. The sacral promontory surface is prepared and 1 or 2 non-reabsorbable 0.0 sutures are placed into the sacral periosteum about 2 cm below the promontory. A sub-peritoneal tunnel is created through which meshes are passed avoiding traction to the sacrum. The peritoneum is closed over the meshes.
Primary Outcome Measure Information:
Title
Operative morbidity and adverse events
Description
Operative morbidity according to Clavien-Dindo classification, measure of perioperative pain with Visual Analogue Score VAS, post-operative adverse events constitute the outcome measures, together with operating time, intra-operative blood loss and length of hospital stay.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Subjective and objective success rate, Patient satisfaction
Description
Success rate: subjective success is absence of symptoms related to prolapse or incontinence using Urogenital Distress Inventory (URI-6) and Impact Incontinence Quality of Life (IIQ-7). Patient satisfaction is defined by replies to the questions of whether the patient is satisfied and would repeat the operation. Objective success is defined as no vaginal prolapse greater or equal to grade 2 at any vaginal site, while the patient performed Valsalva's manouever.
Time Frame
2 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Study inclusion criteria were POP > 2, age ≥ 18 and ≤ 75 yrs. Exclusion Criteria: Malignant uterus lesion (leiomyoma, fibromyoma, cervical or endometrial carcinoma) Active pelvic inflammatory disease, Known hypersensitivity to synthetic materials (polypropylene or polyglycolic acid) Pregnancy or lactation Evidence of clinically significant cardiovascular, renal, hepatic or respiratory diseases; and Any condition that in the judgment of the investigators would interfere with the subject's ability to provide informed consent, comply with study instructions, place the subject at increased risk, or which might confound interpretation of study results.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Massimo Porena, MD Prof in Chief
Organizational Affiliation
Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology
Official's Role
Study Director
Facility Information:
Facility Name
Department of Medical-Surgical Specialties and Public Health, Section of Urology and Andrology
City
Perugia
ZIP/Postal Code
06100
Country
Italy

12. IPD Sharing Statement

Citations:
PubMed Identifier
15964131
Citation
Costantini E, Mearini L, Bini V, Zucchi A, Mearini E, Porena M. Uterus preservation in surgical correction of urogenital prolapse. Eur Urol. 2005 Oct;48(4):642-9. doi: 10.1016/j.eururo.2005.04.022.
Results Reference
background
PubMed Identifier
17011699
Citation
Costantini E, Zucchi A, Giannantoni A, Mearini L, Bini V, Porena M. Must colposuspension be associated with sacropexy to prevent postoperative urinary incontinence? Eur Urol. 2007 Mar;51(3):788-94. doi: 10.1016/j.eururo.2006.08.034. Epub 2006 Sep 5.
Results Reference
background
PubMed Identifier
18639302
Citation
Costantini E, Lazzeri M, Bini V, Del Zingaro M, Zucchi A, Porena M. Burch colposuspension does not provide any additional benefit to pelvic organ prolapse repair in patients with urinary incontinence: a randomized surgical trial. J Urol. 2008 Sep;180(3):1007-12. doi: 10.1016/j.juro.2008.05.023. Epub 2008 Jul 17.
Results Reference
background
Links:
URL
http://www.unipg.it
Description
university of perugia

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Surgical Correction of Pelvic Organ Prolapse

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