Long‐term outcomes of primary cystocele repair by transvaginal mesh surgery versus laparoscopic mesh sacropexy: extended follow‐up of the PROSPERE multicentre randomised trial

2021 ◽  
Author(s):  
Jean‐Philippe Lucot ◽  
Michel Cosson ◽  
Stephane Verdun ◽  
Philippe Debodinance ◽  
Georges Bader ◽  
...  
Keyword(s):  
Randomised Trial ◽  
Transvaginal Mesh ◽  
Long Term Outcomes ◽  
Mesh Surgery

scholarly journals Long-term outcomes of transvaginal mesh surgery for pelvic organ prolapse: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojuan Wang ◽  
Yisong Chen ◽  
Changdong Hu ◽  
Keqin Hua
Keyword(s):  
Pelvic Organ Prolapse ◽  
Patient Characteristics ◽  
Pelvic Organ ◽  
Transvaginal Mesh ◽  
Recurrence Rates ◽  
Kaplan Meier ◽  
Mesh Surgery ◽  
Patient Global Impression

Abstract Background The objective of this study was to evaluate the overall outcomes and complications of transvaginal mesh (TVM) placement for the management of pelvic organ prolapse (POP) with different meshes with a greater than 10-years of follow-up. Methods We performed a retrospective review of patients with POP who underwent prolapse repair surgery with placement of transvaginal mesh (Prolift kit or self-cut Gynemesh) between January 2005 and December 2010. Baseline of patient characteristics were collected from the patients’ medical records. During follow-up, the anatomical outcomes were evaluated using the POP Quantification system, and the Patient Global Impression of Improvement (PGI-I) was used to assess the response of a condition to therapy. Overall postoperative satisfaction was assessed by the following question: “What is your overall postoperative satisfaction, on a scale from 0 to 10?”. Relapse-free survival was analyzed using Kaplan–Meier curves. Results In total, 134 patients were included. With a median 12-year (range 10–15) follow-up, 52 patients (38.8%) underwent TVM surgery with Prolift, and Gynemesh was used 82 (61.2%). 91% patients felt that POP symptom improved based on the PGI-I scores, and most satisfied after operation. The recurrence rates of anterior, apical and posterior compartment prolapse were 5.2%, 5.2%, and 2.2%, respectively. No significant differences in POP recurrence, mesh-associated complications and urinary incontinence were noted between TVM surgery with Prolift versus Gynemesh. Conclusions Treatment of POP by TVM surgery exhibited long-term effectiveness with acceptable morbidity. The outcomes of the mesh kit were the same as those for self-cutmesh.

Transvaginal mesh surgery for pelvic organ prolapse does not affect sexual function at long term follow up

2019 ◽  
Vol 18 (9) ◽  
pp. e3177
Author(s):  
S. Serni ◽  
S. Morselli ◽  
P. Verrienti ◽  
M. Di Camillo ◽  
L. Gemma ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Sexual Function ◽  
Pelvic Organ ◽  
Transvaginal Mesh ◽  
Mesh Surgery ◽  
Long Term Follow Up

Transvaginal mesh surgery for pelvic organ prolapse does not affect sexual function at long term follow up

2019 ◽  
Vol 240 ◽  
pp. 282-287
Author(s):  
Simone Morselli ◽  
Vincenzo Li Marzi ◽  
Pierangelo Verrienti ◽  
Maurizio Serati ◽  
Matteo Di Camillo ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Sexual Function ◽  
Pelvic Organ ◽  
Transvaginal Mesh ◽  
Mesh Surgery ◽  
Long Term Follow Up

Long-term outcomes of transvaginal mesh (TVM) In patients with pelvic organ prolapse: A 5-year follow-up

2018 ◽  
Vol 225 ◽  
pp. 90-94 ◽  
Author(s):  
Enrique P. Ubertazzi ◽  
Hector F.E. Soderini ◽  
Adrian J.M. Saavedra Sanchez ◽  
Camilo Fonseca Guzman ◽  
Lucila I. Paván
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Transvaginal Mesh ◽  
Long Term Outcomes

scholarly journals Excision of elongated cervix during reconstructive surgery in patients with pelvic organ prolapse – pro et contra

2019 ◽  
Vol 4 (3) ◽  
pp. 34-40
Author(s):  
I. A. Eizenach ◽  
V. V. Vlasova ◽  
V. G. Mozes
Keyword(s):  
Pelvic Organ Prolapse ◽  
Reconstructive Surgery ◽  
Primary Outcome ◽  
Pelvic Organ ◽  
Cervical Length ◽  
Long Term Outcomes ◽  
Cervical Elongation ◽  
Mesh Surgery

Aim. To determine whether the cervical elongation affects long-term outcomes of reconstructive surgery of pelvic organ prolapse.Materials and Methods. We consecutively enrolled 99 patients with grade 2-3 pelvic organ prolapse (Pelvic Organ Prolapse Quantification System) who underwent vaginal mesh surgery. Volume and length of the cervix were measured using vaginal ultrasonography immediately before the surgery. Cervical elongation was defined as cervix > 6 cm in length (n = 55). Upon 1 year of follow-up, we evaluated the primary outcome (pelvic organ prolapse) and secondary outcomes (cervical length and volume).Results. After 1 year of follow-up, cervical elongation was still detected in 18.1% of patients with cervical elongation before the surgery but not in those without (p = 0.008). Dyspareunia was documented in 14.5% and 2.2% of women with and without cervical elongation, respectively (p = 0.034). In patients with cervical elongation, the length of the cervix before the surgery and after 1 year of follow-up was 7.6 (7; 7.9) cm and 8.4 (7.9; 8.9) cm, respectively (p = 0.001); the respective values of cervical volume were 23.7 (23.4; 24.4) cm3 and 26.9 (25.7; 31.9) cm3 , respectively (p = 0.001); however, these differences were insignificant in patients without cervical elongation.Conclusion. Cervical excision may be recommended for the patients with pelvic organ prolapse and concurrent cervical elongation (length of the cervix > 6 cm). Cervical preservation in such patients may lead to progression of the elongation even after the correction of pelvic organ prolapse. 

Optimal Dose of Antithymocyte Globulin in Conditioning Regimens for Unmanipulated Haploidentical Haematopoietic Stem Cell Transplantation: Long-Term Outcomes of a Prospective Randomised Trial

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3433-3433
Author(s):  
Yingjun Chang ◽  
Yu Wang ◽  
Xiao-Dong Mo ◽  
Xiao-Hui Zhang ◽  
Lan-Ping Xu ◽  
...  
Keyword(s):  
Antithymocyte Globulin ◽  
Randomised Trial ◽  
Optimal Dose ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Prospective Randomised Trial ◽  
Conditioning Regimens ◽  
Disease Free

Abstract Background: Antithymocyte globulin (ATG) is an important component of conditioning regimens to prevent severe GVHD in patients undergoing unmanipulated haploidentical stem cell transplantation (haplo-SCT). However, the optimal dose of ATG is unknown. Methods: In this open-label extension of a prospective, randomised trial, we compared the long-term outcomes of two ATG doses used in myeloablative conditioning before unmanipulated haplo-HSCT. Patients were randomly assigned (1:1) to 10 mg/kg (ATG-10) or 6 mg/kg (ATG-6) ATG. Patients and individuals assessing outcomes were masked to treatment allocation. Analysis of disease-free survival (DFS), GVHD-free/relapse-free survival (GRFS), relapse, non-relapse mortality (NRM), and chronic GVHD (cGVHD) included the entire population. Late effects were assessed in disease-free patients who had survived for at least 6 months and had received regular follow-up evaluations. Results: Between December 2010 and May 2012, 224 patients were recruited. The median follow-up period was 1614 days (28-1929 days). The 5-year cumulative incidence was comparable between the ATG-6 and ATG-10 groups for relapse (12·8% vs. 13·4%, p=0·832) and NRM (11·6% vs. 17·0%, p=0·263). The 5-year probability of DFS was comparable between groups (75·6% vs. 69·6%, p=0·283). The 5-year cumulative incidence was higher with ATG-6 for cGVHD (75·0% vs. 56·3%, p=0·007; moderate-to-severe cGVHD: 56·3% vs. 30·4%, p<0·0001) and late effects (71·2% vs. 56·9%, p=0·043). The 5-year probability of GRFS was higher with ATG-10 (41·0% vs. 26·8%, p=0·008). In the multivariate analysis, ATG-10 was associated with lower cGVHD risk and improved GRFS. Conclusions: ATG 10 mg/kg may be the optimal dose for conditioning regimens before unmanipulated haplo-SCT. Disclosures No relevant conflicts of interest to declare.

Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 264-274
Author(s):  
Dagmar Krajíčková ◽  
Antonín Krajina ◽  
Miroslav Lojík ◽  
Martina Mulačová ◽  
Martin Vališ
Keyword(s):  
Death Rate ◽  
Long Term Outcomes ◽  
Single Centre ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Angioplasty And Stenting ◽  
Aggressive Medical Management ◽  
Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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