GYNECARE PROSIMA* Procedure Versus Modified Total Pelvic Floor Reconstructive Surgery for Uterine Prolapse Stage III

NCT ID: NCT01396109

Last Updated: 2012-12-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-03-31

Study Completion Date

2016-03-31

Brief Summary

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Pelvic Organ prolapse (a feeling of bulge in the vagina) may cause some distressing symptoms such as loss of control of the bowel or bladder, and may also cause problems with patient's sex life. The primary treatment is surgery, sometimes a mesh is placed in the pelvis to support the weakened tissues, but mesh implants can cause complications.

This study is designed to determine the effectiveness and safety of GYNECARE PROSIMA\* pelvic floor repair system compared with the modified total pelvic floor reconstructive surgery with mesh for the treatment of uterine prolapse.

Patients enrolled into the study will be followed up for up to 3 years after surgery. Evaluation will take place during surgery and postoperative visit. Stage of prolapse before and after surgery, patient satisfaction through quality of life and sexual function questionnaires before and after surgery, and peri-operative complication rates will be evaluated.

Detailed Description

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Pelvic organ prolapse is a common problem. The high rate of failure has led to an increasing use of synthetic grafts to augment vaginal repair procedures to obtain more durable results. In 2005, the investigators began to perform modified pelvic floor reconstruction surgery with mesh. The nation-wide multicenter prospective clinical trial data showed that it was safe, efficient and cost-effective. No severe intraoperative complications were recorded and the recurrence rate after 1 year follow-up was 8.1%. Quality of life improved significantly from the baseline, while the sexual function did not change.

The GYNECARE PROSIMA\* system is a new technique. It provides a simplified unanchored mesh repair, avoiding the need for dissection outside the pelvic cavity and avoids passage of suture and instruments through the obturator foramen and sacrospinous ligament, thus making surgery much simpler to perform and reduces the risk of the specific complications that can occur with suture placement or tunneling. 1-year anatomic and functional outcomes of international multicenter prospective study for POP-Q Stage I I-III pelvic organ prolapse showed the objective success rate was 76.9%, pelvic symptoms, quality of life, and sexual function improved significantly from baseline.

In clinical practice, many women have symptomatic POP-Q Stage III uterine prolapse, which requires surgical correction. They are relatively young, and therefore care more about the long-term outcomes and quality of life after procedure. The purpose of this multicenter, prospective, and comparative study is to evaluate the effectiveness and safety of these two procedures concomitantly performed with vaginal hysterectomy (TVH) in the treatment of symptomatic POP-Q Stage III uterine prolapse in China.

Conditions

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Uterine Prolapse Stage III

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group I

Intervention: Procedure: TVH and GYNECARE PROSIMA\* Pelvic Floor Repair System

Group Type ACTIVE_COMPARATOR

Procedure: TVH and GYNECARE PROSIMA* Pelvic Floor Repair System

Intervention Type PROCEDURE

Subjects of this group were submitted to surgical treatment with GYNECARE PROSIMA\* Pelvic Floor Repair System concurrently with transvaginal hysterectomy.

Group II

Intervention: Procedure: TVH and Modified Pelvic Floor Reconstruction Surgery with Mesh

Group Type ACTIVE_COMPARATOR

Procedure: TVH and Modified Pelvic Floor Reconstruction Surgery with mesh

Intervention Type PROCEDURE

Subjects of this group were submitted to surgical treatment of Modified Pelvic Floor Reconstruction Surgery with mesh concurrently with transvaginal hysterectomy.

Interventions

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Procedure: TVH and GYNECARE PROSIMA* Pelvic Floor Repair System

Subjects of this group were submitted to surgical treatment with GYNECARE PROSIMA\* Pelvic Floor Repair System concurrently with transvaginal hysterectomy.

Intervention Type PROCEDURE

Procedure: TVH and Modified Pelvic Floor Reconstruction Surgery with mesh

Subjects of this group were submitted to surgical treatment of Modified Pelvic Floor Reconstruction Surgery with mesh concurrently with transvaginal hysterectomy.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Candidates with symptomatic uterine prolapse of ICS POP-Q Stage III(with any degree of vaginal prolapse), suitable for surgical repair.
* Vaginal hysterectomy will be performed concurrently.
* Without stress urinary incontinence or occult stress urinary incontinence with no need of mid-urethral sling procedures for incontinence to be performed.
* Age ≥ 60 years.
* Agrees to participate in the study, including completion of all study-related procedures, evaluations and questionnaires, and documents this agreement by signing the Ethics Committee / IRB approved informed consent.

Exclusion Criteria

* Additional surgical intervention concurrent to the procedure (e.g. sacrocolpopexy, paravaginal repair, tubal sterilisation).
* Previous repair of pelvic organ prolapse involving insertion of mesh.
* Experimental drug or experimental medical device within 3 months prior to the planned procedure.
* Active genital, urinary or systemic infection at the time of the surgical procedure. Surgery may be delayed in such subjects until the infection is cleared.
* Coagulation disorder or on therapeutic anticoagulant therapy at the time of surgery.
* History of chemotherapy or pelvic radiation therapy.
* Systemic disease known to affect bladder or bowel function (e.g. Parkinson's disease, multiple sclerosis, spinal cord injury or trauma).
* Current evaluation or treatment for chronic pelvic pain (e.g. interstitial cystitis, endometriosis, coccydynia, vulvodynia).
* Nursing or pregnant or intends future pregnancy.
* Chronic cough not well-controlled.
* BMI≥30.
* In the investigator's opinion, any medical condition or psychiatric illness that could potentially be life threatening or affect their ability to complete the study visits according to this protocol.
Minimum Eligible Age

60 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Peking Union Medical College Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lan Zhu

Role: PRINCIPAL_INVESTIGATOR

Peking Union Medical College Hospital

Locations

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Hefei Maternity and Child Health Hospital

Hefei, Anhui, China

Site Status ACTIVE_NOT_RECRUITING

Gansu Maternity and Child Health Hospital

Lanzhou, Gansu, China

Site Status RECRUITING

Hebei Provincial Hospital

Shijiazhuang, Hebei, China

Site Status ACTIVE_NOT_RECRUITING

the First Affliliated Hospital of Zhengzhou University

Zhengzhou, Henan, China

Site Status RECRUITING

Wuxi Maternal and Child Health Hospital, Nanjing Medical University

Wuxi, Jiangsu, China

Site Status RECRUITING

Maternal and Child Health Hospital of Jiangxi Province

Nanchang, Jiangxi, China

Site Status ACTIVE_NOT_RECRUITING

Laizhou Municipal People's Hospital

Laizhou, Shandong, China

Site Status RECRUITING

Women's Hospital School of Medicine Zhejiang University

Hangzhou, Zhejiang, China

Site Status RECRUITING

Peking University Third Hospital

Beijing, , China

Site Status RECRUITING

Peking Union Medical College Hospital

Beijing, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Lan Zhu

Role: CONTACT

Phone: 86-10-65296238

Email: [email protected]

Juan Chen

Role: CONTACT

Phone: 86-13521354364

Email: [email protected]

Facility Contacts

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Qing Liu

Role: primary

Mei Ji

Role: primary

Jian Gong

Role: primary

Jie-liang Li

Role: primary

Hangmei Jin

Role: primary

Jin-song Han

Role: primary

Lan Zhu

Role: primary

Juan Chen

Role: backup

Other Identifiers

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pumch-gyn-01

Identifier Type: -

Identifier Source: org_study_id