Sacro-hysteropexy Using Proline Mesh Versus Mersilene Tape in Apical Prolapse

NCT ID: NCT05196542

Last Updated: 2022-01-19

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

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-01

Study Completion Date

2021-12-01

Brief Summary

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Sacro-hysteropexy Using Proline Mesh Versus Mersilene Tape in Apical Prolapse: a Randomized Controlled Study .Aim of This Study is to Compare Between Using Poly-proline Mesh Versus Mersilene Tape in Abdominal Sacrohysteropexy Repairing Apical Prolapse Stage 2 or More. Outcome Measures: Short Term: investigators Will Evaluate Operative Time, Blood Loss, Hospital Stay Duration, Occurrence of Major Complications, Episodes of Constipation, Urinary Retention and Urinary Tract Infection. Long Term (After 1 year): investigators Will Evaluate Occurrence of Relapse as Well as Late Complications. Local Symptoms, Quality of Life and Sexual Function Will be Evaluated by a Questioner Before and After Surgery

Detailed Description

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Aim of this study is to compare between using poly-proline mesh versus mersilene tape in abdominal sacrohysteropexy repairing apical prolapse stage ӀӀ or more.

Study Design: This will be a prospective randomized controlled non blind study will include cases with apical prolapse stage 2 or more undergoing abdominal sling between October 2019 and September 2020 in Obstetrics and Gynecology Department, Ain Shams University Hospital and menofia university hospital.

Inclusion Criteria: Women planning sacrohysteropexy for stage 2, 3, or 4 prolapse with or without stress urinary incontinence, Age between 25 and 45, Patient has no uterine pathology necessitate hysterectomy and patient wish to retain her uterus.

Exclusion Criteria:Unfitness for anesthesia, Present pelvic inflammatory disease, Previously identified or suspected massive adhesions between sigmoid and pre-sacral peritoneum, Previous pelvic operations or trial of sling operation.

Prolapse is staged with the use of the pelvic-organ-prolapse quantification (POP-Q) system, a standardized quantitative method for assessment of prolapse. PISQ-12 assesses the sexual function of the woman with prolapse. Urinary incontinence is ruled out by history, examination and urodynamic study.

Randomization using a list of computer-generated random sample into two groups. Group1:patients with apical prolapse who will do Sacro hysteropexy using poly-proline mesh, Group 2:patients with apical prolapse who will do Sacro hysteropexy using mersilene tape.

Technique of procedure: Participants will receive bowel preparation the day before surgery, Prophylactic antibiotics will be given preoperatively.

Abdominal Sacro colpopexy will be performed by laparotomy under general or spinal anesthesia, preferably using a pfannenstiel incision. In group (1) using poly-proline mesh to be fixed to the cervix at the level of the internal os at the uterosacral ligament and the other end to the longitudinal vertebral ligament by non-absorbable sutures. Excess mesh is trimmed and removed.

In group (2) using mersilene tape with double needle to anchor the cervix at the level of the internal os by stitches and then fixed to the longitudinal vertebral ligament. Mesh or tape should be completely covered by peritoneum.

If the patient complains of stress urinary incontinence, it will be managed by trans-obturator tape (TOT) and procedure will be recorded.

Outcome measures: Short term, investigators will evaluate operative time, blood loss, hospital stay duration, occurrence of major complications, episodes of constipation, urinary retention and urinary tract infection.

Long term (after 1year), investigators will evaluate occurrence of relapse as well as late complications. Also local symptoms, quality of life and sexual function will be evaluated by a questioner before and after surgery.

Sample size: Study will include cases with apical prolapse stage ӀӀ or more undergoing abdominal sling between October 2019 and September 2020 in Obstetrics and Gynecology Department, Ain Shams University Hospital and menofia university hospital. On prevalence of 7% and power of 80, number of cases will be estimated of 50 cases in each group.

Conditions

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Apical Prolapse

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants
participants will be aware of procedure but unaware of the material used for repair

Study Groups

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mersilene tape arm (ETHICON, polyester 5mm double needle)

Group 1: patients with apical prolapse who will do Sacro hysteropexy using mersilene tape (polyester 5mm tape with double needle)

Group Type EXPERIMENTAL

patients with apical prolapse who will do Sacro hysteropexy using mersilene tape

Intervention Type PROCEDURE

comparison between standard poly prolene mesh and the poly ester mersilene tape in Sacro hysteropexy surgical procedure

polyproline mesh arm (ETHICON, polyprolene mesh)

Group 2: patients with apical prolapse who will do Sacro hysteropexy using poly-proline mesh

Group Type OTHER

patients with apical prolapse who will do Sacro hysteropexy using mersilene tape

Intervention Type PROCEDURE

comparison between standard poly prolene mesh and the poly ester mersilene tape in Sacro hysteropexy surgical procedure

Interventions

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patients with apical prolapse who will do Sacro hysteropexy using mersilene tape

comparison between standard poly prolene mesh and the poly ester mersilene tape in Sacro hysteropexy surgical procedure

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Women planning sacrohysteropexy for stage 2, 3, or 4 prolapse with or without stress urinary incontinence.

* Age between 25 and 45
* Patient has no uterine pathology necessitate hysterectomy and patient wish to retain her uterus.

Exclusion Criteria

Unfitness for anesthesia

* Present pelvic inflammatory disease
* Previously identified or suspected massive adhesions between sigmoid and pre-sacral peritoneum.
* Previous pelvic operations or trial of sling operation
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Mohamed Elsibai Anter

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Elsibai Anter

principal investigator

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Menoufia University

Shibīn al Kawm, Menoufia, Egypt

Site Status

Countries

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Egypt

Other Identifiers

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Simple Mail Transfer Protocol

Identifier Type: -

Identifier Source: org_study_id

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