Outcomes and predictors of failure of trocar-guided vaginal mesh surgery for pelvic organ prolapse
Objective The objective of the study was to compare the 1 year conventional and composite outcomes of trocar-guided vaginal mesh surgery and the identification of the predictors of failure. Study Design This was a prospective observational cohort study. Failure outcome definitions were as follows: I...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2012-05, Vol.206 (5), p.440.e1-440.e8 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Milani, Alfredo L., MD Withagen, Mariella I.J., MD Vierhout, Mark E., MD, PhD |
| description | Objective The objective of the study was to compare the 1 year conventional and composite outcomes of trocar-guided vaginal mesh surgery and the identification of the predictors of failure. Study Design This was a prospective observational cohort study. Failure outcome definitions were as follows: I, prolapse stage II or greater in mesh treated compartments; II, overall prolapse stage II or greater; III, composite outcome of overall prolapse greater than the hymen and the presence of bulge symptoms or repeat surgery. We used logistic regression to identify predictors of failure. Results The results of the study were 1 year follow-up of 433 patients. Treated compartment failure (I) was 15% (95% confidence interval [CI], 12–19). Overall prolapse failure (II) was 41% (95% CI, 36–45). Composite failure (III) was 9% (95% CI, 7–13). Predictor of failure in all outcomes was the combined anterior/posterior mesh with the uterus in situ. Conclusion Outcome of prolapse surgery depends on outcome definition. The mesh treated compartment failure outcome (I) and the composite failure outcome (III) appeared not to be statistically different. Consistent factor for failure in all outcomes was the combined anterior/posterior mesh insertion with the uterus in situ. |
| doi_str_mv | 10.1016/j.ajog.2012.01.039 |
| format | Article |
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Study Design This was a prospective observational cohort study. Failure outcome definitions were as follows: I, prolapse stage II or greater in mesh treated compartments; II, overall prolapse stage II or greater; III, composite outcome of overall prolapse greater than the hymen and the presence of bulge symptoms or repeat surgery. We used logistic regression to identify predictors of failure. Results The results of the study were 1 year follow-up of 433 patients. Treated compartment failure (I) was 15% (95% confidence interval [CI], 12–19). Overall prolapse failure (II) was 41% (95% CI, 36–45). Composite failure (III) was 9% (95% CI, 7–13). Predictor of failure in all outcomes was the combined anterior/posterior mesh with the uterus in situ. Conclusion Outcome of prolapse surgery depends on outcome definition. The mesh treated compartment failure outcome (I) and the composite failure outcome (III) appeared not to be statistically different. Consistent factor for failure in all outcomes was the combined anterior/posterior mesh insertion with the uterus in situ.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2012.01.039</identifier><identifier>PMID: 22397899</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; failure ; Female ; Follow-Up Studies ; Gynecologic Surgical Procedures - instrumentation ; Gynecologic Surgical Procedures - methods ; Gynecology. Andrology. Obstetrics ; Humans ; Logistic Models ; Medical sciences ; mesh ; Middle Aged ; Multivariate Analysis ; Obstetrics and Gynecology ; Odds Ratio ; outcome ; pelvic organ prolapse ; Pelvic Organ Prolapse - surgery ; Prospective Studies ; risk factor ; Risk Factors ; Surgical Mesh ; Surveys and Questionnaires ; Treatment Failure ; Vagina - surgery ; Young Adult</subject><ispartof>American journal of obstetrics and gynecology, 2012-05, Vol.206 (5), p.440.e1-440.e8</ispartof><rights>Mosby, Inc.</rights><rights>2012 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-99f7162c09276bc5a1749de71bf1a791fab6cb4f7c40874c84b1f7f0b6f2bf0c3</citedby><cites>FETCH-LOGICAL-c441t-99f7162c09276bc5a1749de71bf1a791fab6cb4f7c40874c84b1f7f0b6f2bf0c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ajog.2012.01.039$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25856870$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22397899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Milani, Alfredo L., MD</creatorcontrib><creatorcontrib>Withagen, Mariella I.J., MD</creatorcontrib><creatorcontrib>Vierhout, Mark E., MD, PhD</creatorcontrib><title>Outcomes and predictors of failure of trocar-guided vaginal mesh surgery for pelvic organ prolapse</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective The objective of the study was to compare the 1 year conventional and composite outcomes of trocar-guided vaginal mesh surgery and the identification of the predictors of failure. Study Design This was a prospective observational cohort study. Failure outcome definitions were as follows: I, prolapse stage II or greater in mesh treated compartments; II, overall prolapse stage II or greater; III, composite outcome of overall prolapse greater than the hymen and the presence of bulge symptoms or repeat surgery. We used logistic regression to identify predictors of failure. Results The results of the study were 1 year follow-up of 433 patients. Treated compartment failure (I) was 15% (95% confidence interval [CI], 12–19). Overall prolapse failure (II) was 41% (95% CI, 36–45). Composite failure (III) was 9% (95% CI, 7–13). Predictor of failure in all outcomes was the combined anterior/posterior mesh with the uterus in situ. Conclusion Outcome of prolapse surgery depends on outcome definition. The mesh treated compartment failure outcome (I) and the composite failure outcome (III) appeared not to be statistically different. Consistent factor for failure in all outcomes was the combined anterior/posterior mesh insertion with the uterus in situ.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>failure</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gynecologic Surgical Procedures - instrumentation</subject><subject>Gynecologic Surgical Procedures - methods</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Medical sciences</subject><subject>mesh</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Obstetrics and Gynecology</subject><subject>Odds Ratio</subject><subject>outcome</subject><subject>pelvic organ prolapse</subject><subject>Pelvic Organ Prolapse - surgery</subject><subject>Prospective Studies</subject><subject>risk factor</subject><subject>Risk Factors</subject><subject>Surgical Mesh</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Failure</subject><subject>Vagina - surgery</subject><subject>Young Adult</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kkGL1DAUx4Mo7uzqF_AguQheWl_SNmlABFl0FRb2oJ5Dmr7U1E4zJu3AfHtTZlTw4CkJ_P7vJb8XQl4wKBkw8WYszRiGkgPjJbASKvWI7BgoWYhWtI_JDgB4oSrZXpHrlMbtyBV_Sq44r5RsldqR7mFdbNhjombu6SFi7-0SYqLBUWf8tEbctksM1sRiWH2PPT2awc9mojn2naY1DhhP1IVIDzgdvaUhDmbOxcJkDgmfkSfOTAmfX9Yb8u3jh6-3n4r7h7vPt-_vC1vXbCmUcpIJbkFxKTrbGCZr1aNknWNGKuZMJ2xXO2lraGVt27pjTjrohOOdA1vdkNfnurnxzxXTovc-WZwmM2NYk87OoFa8Ek1G-Rm1MaQU0elD9HsTTxnaOKFHvbnVm1sNTGe3OfTyUn_t9tj_ifyWmYFXF8AkayYXzWx9-ss1bSNaCZl7e-Yw2zh6jDpZj7PN7iPaRffB__8e7_6J28nPPnf8gSdMY1hjHk5-r045o79sY98-AeMArIKm-gUNeq2G</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Milani, Alfredo L., MD</creator><creator>Withagen, Mariella I.J., MD</creator><creator>Vierhout, Mark E., MD, PhD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Outcomes and predictors of failure of trocar-guided vaginal mesh surgery for pelvic organ prolapse</title><author>Milani, Alfredo L., MD ; Withagen, Mariella I.J., MD ; Vierhout, Mark E., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-99f7162c09276bc5a1749de71bf1a791fab6cb4f7c40874c84b1f7f0b6f2bf0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>failure</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gynecologic Surgical Procedures - instrumentation</topic><topic>Gynecologic Surgical Procedures - methods</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Medical sciences</topic><topic>mesh</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Obstetrics and Gynecology</topic><topic>Odds Ratio</topic><topic>outcome</topic><topic>pelvic organ prolapse</topic><topic>Pelvic Organ Prolapse - surgery</topic><topic>Prospective Studies</topic><topic>risk factor</topic><topic>Risk Factors</topic><topic>Surgical Mesh</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Failure</topic><topic>Vagina - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Milani, Alfredo L., MD</creatorcontrib><creatorcontrib>Withagen, Mariella I.J., MD</creatorcontrib><creatorcontrib>Vierhout, Mark E., MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Milani, Alfredo L., MD</au><au>Withagen, Mariella I.J., MD</au><au>Vierhout, Mark E., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes and predictors of failure of trocar-guided vaginal mesh surgery for pelvic organ prolapse</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>206</volume><issue>5</issue><spage>440.e1</spage><epage>440.e8</epage><pages>440.e1-440.e8</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective The objective of the study was to compare the 1 year conventional and composite outcomes of trocar-guided vaginal mesh surgery and the identification of the predictors of failure. Study Design This was a prospective observational cohort study. Failure outcome definitions were as follows: I, prolapse stage II or greater in mesh treated compartments; II, overall prolapse stage II or greater; III, composite outcome of overall prolapse greater than the hymen and the presence of bulge symptoms or repeat surgery. We used logistic regression to identify predictors of failure. Results The results of the study were 1 year follow-up of 433 patients. Treated compartment failure (I) was 15% (95% confidence interval [CI], 12–19). Overall prolapse failure (II) was 41% (95% CI, 36–45). Composite failure (III) was 9% (95% CI, 7–13). Predictor of failure in all outcomes was the combined anterior/posterior mesh with the uterus in situ. Conclusion Outcome of prolapse surgery depends on outcome definition. The mesh treated compartment failure outcome (I) and the composite failure outcome (III) appeared not to be statistically different. Consistent factor for failure in all outcomes was the combined anterior/posterior mesh insertion with the uterus in situ.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22397899</pmid><doi>10.1016/j.ajog.2012.01.039</doi><tpages>2</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Biological and medical sciences failure Female Follow-Up Studies Gynecologic Surgical Procedures - instrumentation Gynecologic Surgical Procedures - methods Gynecology. Andrology. Obstetrics Humans Logistic Models Medical sciences mesh Middle Aged Multivariate Analysis Obstetrics and Gynecology Odds Ratio outcome pelvic organ prolapse Pelvic Organ Prolapse - surgery Prospective Studies risk factor Risk Factors Surgical Mesh Surveys and Questionnaires Treatment Failure Vagina - surgery Young Adult |
| title | Outcomes and predictors of failure of trocar-guided vaginal mesh surgery for pelvic organ prolapse |
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