Sacrocolpopexy With Posterior Repair Obstructed Defecation Symptoms

NCT ID: NCT03658395

Last Updated: 2024-12-06

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

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-19

Study Completion Date

2024-04-01

Brief Summary

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Participants who undergo laparoscopic sacrocolpopexy (LSCP) plus posterior repair (PR) will demonstrate greater improvement bowel symptom scores compared to participants who undergo LSCP alone at 3 months postoperatively.

Detailed Description

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Those who provide informed consent will be randomized into either laparoscopic sacrocolpopexy (LSCP) alone or laparoscopic sacrocolpopexy (LSCP) plus posterior repair (PR). Participants will be randomized with equal probability to the LSCP only arm or LSCP plus PR arm.

The surgical technique for LSCP will be similar to that described by Paraiso et al. for LSCP \[14\] and by Elliott et al. for robot-assisted LSCP \[15\], with minor variations. A Y-shaped polypropylene mesh graft, 10 cm in standard length and tailored to each patient's anatomic specifications during surgery, will be used with all SCP procedures.

PR is performed by midline fascial plication. Plication of superficial perineal muscles (perineorrhaphy) is performed in conjunction with PR. All repairs are performed using polydioxanone 2/0 for fascial repair and 4/0 polyglactin suture for skin closure.

Participants will also complete questionnaires and undergo an endovaginal ultrasound (using a 9-16 MHz, 360° rotational transducer, type 8838, BK Medical, Peabody, MA) prior to surgery and three months following surgery.

Conditions

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Vaginal Prolapse

Keywords

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Vaginal, Prolapse, laparoscopic, sacrocolpopexy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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LSCP Only

A Y-shaped polypropylene mesh graft, 10 cm in standard length and tailored to each patient's anatomic specifications during surgery, is used utilizing robot-assisted Laparoscopic Sacrocolopopexy.

Group Type ACTIVE_COMPARATOR

Laparoscopic Sacrocolopopexy

Intervention Type PROCEDURE

The LSCP surgery involves pulling up the bladder, vagina, and rectum using a Y-shaped mesh attached to the lower back bone

LSCP + PR

The Laparoscopic Sacrocolopopexy involves a Y-shaped polypropylene mesh graft, 10 cm in standard length and tailored to each patient's anatomic specifications during surgery, utilizing robot-assisted Laparoscopic Sacrocolopopexy.

In addition, patients will receive posterior repair. Posterior repair is performed by midline fascial plication. Plication of superficial perineal muscles (perineorrhaphy) is performed in conjunction with posterior repair. All repairs are performed using polydioxanone 2/0 for fascial repair and 4/0 polyglactin suture for skin closure.

Group Type ACTIVE_COMPARATOR

Laparoscopic Sacrocolopopexy

Intervention Type PROCEDURE

The LSCP surgery involves pulling up the bladder, vagina, and rectum using a Y-shaped mesh attached to the lower back bone

Posterior repair

Intervention Type PROCEDURE

The PR surgery involves tightening the tissue between the rectum and vagina to reduce vaginal bulging during bowel movements.

Interventions

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Laparoscopic Sacrocolopopexy

The LSCP surgery involves pulling up the bladder, vagina, and rectum using a Y-shaped mesh attached to the lower back bone

Intervention Type PROCEDURE

Posterior repair

The PR surgery involves tightening the tissue between the rectum and vagina to reduce vaginal bulging during bowel movements.

Intervention Type PROCEDURE

Other Intervention Names

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LSCP PR

Eligibility Criteria

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Inclusion Criteria

* Female Gender
* Able to complete English language questionnaires
* Able to complete study visits for 6 months
* Bowel symptom score (PFDI-O) score ≥ 3
* Posterior vaginal bulge ≤2cm beyond the hymen

Exclusion Criteria

* Age \< 21
* Pregnancy
* History of colorectal surgery
* History of pelvic radiation
* Inflammatory bowel disease
* History of prior SCP
Minimum Eligible Age

21 Years

Maximum Eligible Age

80 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Oklahoma

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lieschen Quiroz, MD

Role: PRINCIPAL_INVESTIGATOR

University of Oklahoma

Locations

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University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, United States

Site Status

Countries

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United States

References

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Frick AC, Paraiso MF. Laparoscopic management of incontinence and pelvic organ prolapse. Clin Obstet Gynecol. 2009 Sep;52(3):390-400. doi: 10.1097/GRF.0b013e3181b0bf69.

Reference Type BACKGROUND
PMID: 19661755 (View on PubMed)

Elliott DS, Frank I, Dimarco DS, Chow GK. Gynecologic use of robotically assisted laparoscopy: Sacrocolpopexy for the treatment of high-grade vaginal vault prolapse. Am J Surg. 2004 Oct;188(4A Suppl):52S-56S. doi: 10.1016/j.amjsurg.2004.08.022.

Reference Type BACKGROUND
PMID: 15476652 (View on PubMed)

Other Identifiers

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9457

Identifier Type: -

Identifier Source: org_study_id