Mesh inlay, mesh kit or native tissue repair for women having repeat anterior or posterior prolapse surgery: randomised controlled trial (PROSPECT).

BJOG : an International Journal of Obstetrics and Gynaecology
Cma GlazenerPROSPECT Study Group

Abstract

To compare standard (native tissue) repair with synthetic mesh inlays or mesh kits. Randomised controlled trial. Thirty-three UK hospitals. Women having surgery for recurrent prolapse. Women recruited using remote randomisation. Prolapse symptoms, condition-specific quality-of-life and serious adverse effects. A Mean Pelvic Organ Prolapse Symptom Score at 1 year was similar for each comparison (standard 6.6 versus mesh inlay 6.1, mean difference [MD] -0.41, 95% CI -2.92 to 2.11: standard 6.6 versus mesh kit 5.9, MD -1.21 , 95% CI -4.13 to 1.72) but the confidence intervals did not exclude a minimally important clinical difference. There was no evidence of difference in any other outcome measure at 1 or 2 years. Serious adverse events, excluding mesh exposure, were similar at 1 year (standard 7/55 [13%] versus mesh inlay 5/52 [10%], risk ratio [RR] 1.05 [0.66-1.68]: standard 3/25 [12%] versus mesh kit 3/46 [7%], RR 0.49 [0.11-2.16]). Cumulative mesh exposure rates over 2 years were 7/52 (13%) in the mesh inlay arm, of whom four women required surgical revision; and 4/46 in the mesh kit arm (9%), of whom two required surgical revision. We did not find evidence of a difference in terms of prolapse symptoms from the use of mesh inl...Continue Reading

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Citations

May 30, 2020·BJOG : an International Journal of Obstetrics and Gynaecology·Christopher Maher, Gunter Hartel
Aug 19, 2021·Archives of Gynecology and Obstetrics·Hui LiZhiyuan Dai

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