RCT for Transvaginal Self-cut Mesh vs Mesh-kit for Severe POP

NCT ID: NCT03849157

Last Updated: 2019-02-21

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

312 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-12

Study Completion Date

2022-01-12

Brief Summary

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Pelvic organ prolapse(POP) is a common health problem and has significant negative effects on woman's quality of life. Transvaginal mesh procedure is a durable reconstructive surgery, but the mesh kits are expensive for underdeveloped countries. Our preliminary trial showed that the use of self-tailored mesh had good success rate (91.8% at 1-year follow-up) and low complication rate. The trial is designed to compare self-tailored titanium-coated polypropylene mesh procedure with mesh-kit in the treatment of POP stage III-IV in terms of efficacy, safety and cost-effective .

Detailed Description

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The trial is a randomized controlled multi-center non-inferiority trial. The primary outcome measure is success rate at 1-year follow-up. The second outcomes are subjective improvement of quality of life, complications and costs. Analysis will be performed according to the intention to treat principle. Based on comparable success rate of 90% and 10% as the margin(beta 0.2 and one sided alpha 0.025), about 312 patients in total from 11 centers will be recruited per group including 10% drop-out. The aims of the research are to demonstrate whether self-tailored mesh is non-inferior to the mesh-kit. The finding of this research might influence the treatment selection for POP in China.

Conditions

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Pelvic Organ Prolapse

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
participant and investigator are not blinded. outcome assessor who are in charge of follow-up assement is masked.

Study Groups

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self-cut mesh procedure

This procedure is transvaginal mesh implantation surgery for POP patients. Self-cut mesh procedure is an economic pelvic reconstructive surgical operation with use of specially designed puncture needles and self-cut mesh, which mainly provide anterior and apical compartments support, with posterior compartment reinforced by bridge technique repair. The mesh pieces used in this surgery was cut from a single piece of mesh material(TiLOOP 10\*15cm) which is much cheaper and readily available. Patients could have transvaginal hysterectomy concomitantly.

Group Type ACTIVE_COMPARATOR

pelvic floor reconstructive surgery

Intervention Type PROCEDURE

transvaginal mesh implantation for pelvic organ prolapse

mesh-kit procedure

This procedure is transvaginal mesh implantation surgery for POP patients.Mesh-kit procedure is refered to pelvic floor reconstructive surgery with titanium-coated meshes kit(TiLOOP TOTAL6).Patients could have transvaginal hysterectomy concomitantly.

Group Type ACTIVE_COMPARATOR

pelvic floor reconstructive surgery

Intervention Type PROCEDURE

transvaginal mesh implantation for pelvic organ prolapse

Interventions

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pelvic floor reconstructive surgery

transvaginal mesh implantation for pelvic organ prolapse

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age:More than 50 year with more than 3 years after menopause, or more than 55 years old, but less than 75 years old.
* Subject must have severe apical or anterior vaginal prolapse (stage III-IV), with moderate posterior vaginal prolapse(stage I-II). This is defined as ( C \> +1cm OR Ba \> +1cm, with Bp ≤+1cm by the POP-Q). This is the most common modality of multiple compartment POP in clinic.
* Subject reports a bothersome bulge they can see or feel per PFDI-20, question 3, response of 2 or higher (i.e., responses of "somewhat", "moderately", or "quite a bit").
* Desires transvaginal mesh treatment for primary or recurrent, symptomatic uterovaginal prolapse.
* Concomitant hysterectomy when indicated. But concomitant anti-incontinence surgeries will not be enrolled.
* Subject is willing and able to comply with the follow-up regimen.

Exclusion Criteria

* Subject is pregnant or intends to become pregnant in the future
* Subject has an active or chronic systemic infection including any gynecologic infection, untreated urinary tract infection (UTI) or tissue necrosis
* Subject has history of pelvic organ cancer (e.g. uterine, ovarian, bladder, colo-rectal or cervical)
* Subject has had prior or is currently undergoing radiation, laser therapy, or chemotherapy in the pelvic area
* Subject has taken systemic steroids (within the last month), or immunosuppressive or immunomodulatory treatment (within the last 3 months)
* Subject has systemic connective tissue disease (e.g. scleroderma, systemic lupus erythematosus (SLE), Marfan syndrome, Ehlers Danlos, collagenosis, polymyositis, polymyalgia rheumatica)
* Subject has chronic systemic pain that includes the pelvic area or chronic focal pain that involves the pelvis
* Subject has uncontrolled diabetes mellitus (DM)
* Subject has a known neurologic or medical condition affecting bladder function (e.g., multiple sclerosis, spinal cord injury or stroke with residual neurologic deficit)
* Subject has had previous prolapse repair with mesh in the target compartment
Minimum Eligible Age

53 Years

Maximum Eligible Age

75 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Medstron Medical Co.Ltd

UNKNOWN

Sponsor Role collaborator

Chinese Academy of Medical Sciences

OTHER

Sponsor Role collaborator

LinkDoc Technology (Beijing) Co. Ltd.

INDUSTRY

Sponsor Role collaborator

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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Peking Union Medical College Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Fosha Maternal and Child Health Care Hospital

Foshan, Guangdong, China

Site Status RECRUITING

The First Affiliated Hospital of Guangzhou Medical College

Guangzhou, Guangdong, China

Site Status RECRUITING

Changsha Maternal and Child Health Care Hospital

Changsha, Hunan, China

Site Status RECRUITING

The second Xiangya Hospital of Central South University

Changsha, Hunan, China

Site Status RECRUITING

Wuxi Maternal and Child Health Care Hospital

Wuxi, Jiangsu, China

Site Status RECRUITING

Qilu Hospital of Shandong University

Jinan, Shandong, China

Site Status RECRUITING

Shanxi Provincial People's Hospital

Xi’an, Shanxi, China

Site Status RECRUITING

Sichuan University West China Second University Hospital

Chengdu, Sichuan, China

Site Status RECRUITING

the First Affiliated Hospital of Xinjiang Medical University

Ürümqi, Xinjiang, China

Site Status RECRUITING

the People's Hospital of Xinjiang Uygur Autonomous Region

Ürümqi, Xinjiang, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Lan Zhu

Role: CONTACT

86-10-69155749

Juan Chen

Role: CONTACT

86-10-69155749

Facility Contacts

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Juan Chen

Role: primary

Yuling Wang

Role: primary

xiaowei zhang

Role: primary

Binan Wang

Role: primary

guangshi Tao

Role: primary

Jian Gong

Role: primary

Peishu Liu

Role: primary

Xiangyang Jiang

Role: primary

Ping Wang

Role: primary

Gulina Ababaikeli

Role: primary

Hatiguli Nisier

Role: primary

Other Identifiers

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protocol for TVM

Identifier Type: -

Identifier Source: org_study_id

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