Anterior colporrhaphy (AC) is commonly used for anterior vaginal wall prolapse, but suffers high recurrence rates. This randomized trial assessed whether adding transobturator lateral suspension (TOLS) to AC decreases objective recurrence without compromising patient outcomes. In a cohort of 44 women (POP-Q ≥ 2), AC alone was compared to AC+TOLS over a 1-year follow-up. Results showed significantly lower objective recurrence with the added suspension.
Conducted prospectively at University Medical Centre Maribor (Slovenia), this single-surgeon RCT randomized women with symptomatic anterior vaginal prolapse (POP-Q stage ≥ 2) to receive either standard AC or AC plus bilateral TOLS via non-absorbable suture across the obturator foramen. Primary outcome was objective anatomical recurrence (POP-Q ≥ 2) at 1 year. Secondary outcomes included subjective recurrence, satisfaction (Likert), operative time, postoperative and pelvic sidewall pain, and validated QOL instruments (UIQ-7, CRAIQ-7, POPIQ-7, PFIQ, POPDI-6, UDI-6, PFDI, PISQ).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
44
"Standard AC plus bilateral lateral suspension using non-absorbable sutures passed through the obturator foramen to support lateral vaginal wall."
University Medical Centre Maribor
Maribor, Slovenia
Objective Recurrence Rate
Anatomical recurrence defined as POP-Q stage ≥ 2 in anterior compartment
Time frame: 1 year postoperative
Subjective Recurrence Rate
Subjective recurrence was determined by a positive response to the validated question: "Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?"
Time frame: 1 year postoperative
Patient Satisfaction
5-point Likert scale at 1 year
Time frame: 1 year postoperative
Operative time
Measured in minutes during surgery.
Time frame: 1 year postoperative
Postoperative Pain
Assessed via VAS at discharge and immediate postoperative period
Time frame: 1 year postoperative.
Pelvic Sidewall Pain
Assessed at 1 year postoperative clinical examination, by pressing on obutrator membrane. Assesed as present or absent.
Time frame: 1 year postoperative.
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