Trial Outcomes & Findings for Efficacy Study of Vaginal Mesh for Prolapse (NCT NCT00475540)

NCT ID: NCT00475540

Last Updated: 2022-10-12

Results Overview

3 different measures for Anatomic cure using POPQ measurements: 1. POP-Q at Stage I or less\* (POP-Q points Ba, Bp or C -1 or less); 2. no prolapse beyond the hymen (Ba, Bp or C 0 or less); 3. no prolapse beyond the hymen (Ba, Bp 0 or less) with adequate apical support above the midvagina (C to TVL/2 or less) No bulge symptoms using Pelvic Floor Distress Inventory, PFDI question 3; do you see or feel a bulge in the vaginal area with response of no. Patient Satisfaction using Patient Global Impression of Improvement with response of very much better or much better

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

65 participants

Primary outcome timeframe

3 year

Results posted on

2022-10-12

Participant Flow

From January 3, 2007 to August 1, 2009, 238 women were identified as eligible and 65 randomized (32 to experimental group (mesh) and 33 to control group (non-mesh)). All patients completed 3 month followup. Study recruitment halted at median followup of 9.7 months due to pre-determined criteria of vaginal mesh exposure in 5/32 patients (15.6%) in the mesh arm.

Participant milestones

Participant milestones
Measure
Prolift Mesh
vaginal prolapse repair with anterior or total mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Prolapse Repair Without Mesh
vaginal prolapse repair without mesh (native tissue repair)
3 Months
STARTED
32
33
3 Months
COMPLETED
32
33
3 Months
NOT COMPLETED
0
0
12 Months
STARTED
32
33
12 Months
COMPLETED
32
33
12 Months
NOT COMPLETED
0
0
36 Months
STARTED
33
32
36 Months
COMPLETED
25
26
36 Months
NOT COMPLETED
8
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Prolift Mesh
vaginal prolapse repair with anterior or total mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Prolapse Repair Without Mesh
vaginal prolapse repair without mesh (native tissue repair)
36 Months
Lost to Follow-up
4
4
36 Months
Death
1
2
36 Months
Censored due to reoperation
3
0

Baseline Characteristics

Efficacy Study of Vaginal Mesh for Prolapse

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Prolift Mesh
n=25 Participants
vaginal prolapse repair with anterior or total mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Prolapse Repair Without Mesh
n=26 Participants
vaginal prolapse repair without mesh (native tissue repair)
Total
n=51 Participants
Total of all reporting groups
Age, Continuous
62.6 years
STANDARD_DEVIATION 10.6 • n=5 Participants
63.1 years
STANDARD_DEVIATION 9 • n=7 Participants
62.8 years
STANDARD_DEVIATION 9.8 • n=5 Participants
Sex: Female, Male
Female
25 Participants
n=5 Participants
26 Participants
n=7 Participants
51 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
White
16 Participants
n=5 Participants
17 Participants
n=7 Participants
33 Participants
n=5 Participants
Race/Ethnicity, Customized
African American
6 Participants
n=5 Participants
7 Participants
n=7 Participants
13 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Postmenopausal
23 Participants
n=5 Participants
24 Participants
n=7 Participants
47 Participants
n=5 Participants
Parity
2 number deliveries
n=5 Participants
2 number deliveries
n=7 Participants
2 number deliveries
n=5 Participants
BMI
27.6 kg/m^2
STANDARD_DEVIATION 5.5 • n=5 Participants
28.2 kg/m^2
STANDARD_DEVIATION 6.4 • n=7 Participants
27.9 kg/m^2
STANDARD_DEVIATION 6.0 • n=5 Participants
POP-Q stage
stage 2
7 Participants
n=5 Participants
4 Participants
n=7 Participants
11 Participants
n=5 Participants
POP-Q stage
stage 3
16 Participants
n=5 Participants
18 Participants
n=7 Participants
34 Participants
n=5 Participants
POP-Q stage
stage 4
2 Participants
n=5 Participants
4 Participants
n=7 Participants
6 Participants
n=5 Participants
married
16 Participants
n=5 Participants
19 Participants
n=7 Participants
35 Participants
n=5 Participants
education
High school or less
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
education
completed high school
4 Participants
n=5 Participants
8 Participants
n=7 Participants
12 Participants
n=5 Participants
education
college or graduate
21 Participants
n=5 Participants
17 Participants
n=7 Participants
38 Participants
n=5 Participants
insurance
Private
12 Participants
n=5 Participants
12 Participants
n=7 Participants
24 Participants
n=5 Participants
insurance
medicare
13 Participants
n=5 Participants
14 Participants
n=7 Participants
27 Participants
n=5 Participants
hysterectomy
9 Participants
n=5 Participants
9 Participants
n=7 Participants
18 Participants
n=5 Participants
prior prolapse surgery
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
prior incontinence surgery
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 3 year

3 different measures for Anatomic cure using POPQ measurements: 1. POP-Q at Stage I or less\* (POP-Q points Ba, Bp or C -1 or less); 2. no prolapse beyond the hymen (Ba, Bp or C 0 or less); 3. no prolapse beyond the hymen (Ba, Bp 0 or less) with adequate apical support above the midvagina (C to TVL/2 or less) No bulge symptoms using Pelvic Floor Distress Inventory, PFDI question 3; do you see or feel a bulge in the vaginal area with response of no. Patient Satisfaction using Patient Global Impression of Improvement with response of very much better or much better

Outcome measures

Outcome measures
Measure
Prolift Mesh
n=25 Participants
vaginal prolapse repair with mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Prolapse Repair Without Mesh
n=26 Participants
vaginal prolapse repair without mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Number of Participants With Anatomic Cure at 3 Years
no reoperation/retreatment
20 Participants
21 Participants
Number of Participants With Anatomic Cure at 3 Years
composite stage less than/equal 1, no bulge symptoms, satisfaction very much better or much better
8 Participants
8 Participants
Number of Participants With Anatomic Cure at 3 Years
composite no prolapse beyond hymen, no bulge symptoms, satisfaction very much better or much better
15 Participants
12 Participants

SECONDARY outcome

Timeframe: 3 year

Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire question 5 response of usually or always and tracked resolution, persistence, de novo dyspareunia

Outcome measures

Outcome measures
Measure
Prolift Mesh
n=14 Participants
vaginal prolapse repair with mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Prolapse Repair Without Mesh
n=11 Participants
vaginal prolapse repair without mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Bothersome Dyspareunia
Persistent dyspareunia
5 Participants
5 Participants
Bothersome Dyspareunia
resolution dyspareunia
2 Participants
1 Participants
Bothersome Dyspareunia
de novo dyspareunia
2 Participants
1 Participants

Adverse Events

Prolift Mesh

Serious events: 5 serious events
Other events: 0 other events
Deaths: 1 deaths

Prolapse Repair Without Mesh

Serious events: 0 serious events
Other events: 5 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Prolift Mesh
n=32 participants at risk
vaginal prolapse repair with mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Prolapse Repair Without Mesh
n=33 participants at risk
vaginal prolapse repair without mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Surgical and medical procedures
Surgery/reoperation for mesh exposure
15.6%
5/32 • Number of events 5 • 3 months, 1 year, 3 years
0.00%
0/33 • 3 months, 1 year, 3 years

Other adverse events

Other adverse events
Measure
Prolift Mesh
n=32 participants at risk
vaginal prolapse repair with mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Prolapse Repair Without Mesh
n=33 participants at risk
vaginal prolapse repair without mesh synthetic monofilament polypropylene mesh: Vaginal prolapse repair with mesh
Surgical and medical procedures
suture exposure
0.00%
0/32 • 3 months, 1 year, 3 years
15.2%
5/33 • Number of events 5 • 3 months, 1 year, 3 years

Additional Information

Allie Moses, Manager, Clinical Research Systems and Recruitment Center

MedStar Health Research Institute

Phone: 301-560-7353

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place