The AMPER Study: Evaluation of the Efficacy of Human Amniotic Membrane Grafting in Preventing Mesh Exposure in Vaginal Reconstructive Surgery Using Polypropylene Mesh. (AMPER)
The Amper Study: Amniotic Membrane for the Prevention of Mesh Exposure in Vaginal Reconstructive Surgery
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Ileana Sanger, MD
- Phone Number: 5491149113030
- Email: ilesaenger@me.com
Study Locations
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-
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Buenos Aires, Argentina
- Recruiting
- Hospital J M Penna
-
Contact:
- Ileana Sanger, MD
- Phone Number: 549114911-5555
- Email: Ilesaenger@gmail.com
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Principal Investigator:
- Ileana Sanger, MD
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Pelvic organ prolapse (POP) stage II C or greater, defined as C ≥ +1, in women without prior hysterectomy and/or with a diagnosis of stress urinary incontinence seeking surgical treatment.
- Ability to understand study information and provide written informed consent.
- Availability for follow-up for a minimum of 12 months.
Exclusion Criteria:
- Previous surgery with synthetic mesh (via vaginal or abdominal approach) for POP repair.
- Known adverse reaction to synthetic meshes.
- Unresolved or active chronic pelvic pain.
- History of prior abdominal or pelvic radiation.
- Contraindication to the planned surgical procedure.
- Current pregnancy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: With amniotic membrane
Patients undergoing surgery for pelvic organ prolapse or stress urinary incontinence with polypropylene mesh in whom a dehydrated human amniotic membrane patch was placed over the mesh or sling prior to vaginal closure.
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Sacrospinous Hysteropexy with polypropylene mesh
Retropubic mid-urethral sling (bottom-up approach) using polypropylene mesh for the treatment of stress urinary incontinence.
Transobturator mid-urethral sling (out-in) using polypropylene mesh for the treatment of stress urinary incontinence.
|
|
Active Comparator: without amniotic membrane, surgery alone
Patients undergoing surgery for pelvic organ prolapse or stress urinary incontinence with polypropylene mesh without human amniotic membrane patch
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Sacrospinous Hysteropexy with polypropylene mesh
Retropubic mid-urethral sling (bottom-up approach) using polypropylene mesh for the treatment of stress urinary incontinence.
Transobturator mid-urethral sling (out-in) using polypropylene mesh for the treatment of stress urinary incontinence.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants with Mesh exposure
Time Frame: From enrollment through the end of the 12-month follow-up
|
Comparison of mesh exposure incidence between the control group and the amniotic membrane group through scheduled postoperative follow-up and self-administered questionnaires.
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From enrollment through the end of the 12-month follow-up
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Abbott S, Unger CA, Evans JM, Jallad K, Mishra K, Karram MM, Iglesia CB, Rardin CR, Barber MD. Evaluation and management of complications from synthetic mesh after pelvic reconstructive surgery: a multicenter study. Am J Obstet Gynecol. 2014 Feb;210(2):163.e1-8. doi: 10.1016/j.ajog.2013.10.012. Epub 2013 Oct 11.
- Jacquetin B, Hinoul P, Gauld J, Fatton B, Rosenthal C, Clave H, Garbin O, Berrocal J, Villet R, Salet-Lizee D, Debodinance P, Cosson M. Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 5-year prospective follow-up study. Int Urogynecol J. 2013 Oct;24(10):1679-86. doi: 10.1007/s00192-013-2080-4. Epub 2013 Apr 6.
- Willison N, McPhail C, Seman E, Taheri M, Aryan P, Nguyen T, Yi J, Abbott D, Dune T, Behnia-Willison F. Platelet-Rich Plasma and Fractional CO2 Laser Therapy to Reduce Surgical Intervention for Symptomatic Vaginal Mesh-Related Complications. Int Urogynecol J. 2025 Apr;36(4):903-912. doi: 10.1007/s00192-025-06123-z. Epub 2025 Apr 3.
- Meutia AP, Budinurdjaja P, Fauzi A, Boediono A, Djusad S, Prihartono J, Wuyung PE, Hestiantoro A, Santoso BI. Enhancing Mesh-Tissue Integration in Menopausal Models Using a Platelet-Rich Plasma-Decellularized Amnion Scaffold Sandwich: A Study on Mesh Contraction, Inflammatory Infiltrate, IL-17, CD31, and Collagen Deposition. Int Urogynecol J. 2025 May;36(5):1045-1052. doi: 10.1007/s00192-025-06084-3. Epub 2025 Mar 5.
- Lau HH, Jou QB, Huang WC, Su TH. Amniotic Membrane Graft in the Management of Complex Vaginal Mesh Erosion. J Clin Med. 2020 Jan 28;9(2):356. doi: 10.3390/jcm9020356.
- Dibb B, Woodgate F, Taylor L. When things go wrong: experiences of vaginal mesh complications. Int Urogynecol J. 2023 Jul;34(7):1575-1581. doi: 10.1007/s00192-022-05422-z. Epub 2023 Jan 6.
- Siblini T, Baracy M, Kulkarni S, Mabis C, Hagglund K, Aslam M. Midurethral Sling Mesh Exposure Confers a High Risk of Persistent Stress Urinary Incontinence. Int Urogynecol J. 2024 Jun;35(6):1177-1182. doi: 10.1007/s00192-024-05762-y. Epub 2024 May 4.
- Six JC, Pinsard M, Guerin S, Gasmi A, Coiffic J, Richard C, Haudebert C, Nyangoh Timoh K, Hascoet J, Peyronnet B. Risk factors for stress urinary incontinence recurrence after midurethral sling revision. Int J Urol. 2023 Nov;30(11):1008-1013. doi: 10.1111/iju.15248. Epub 2023 Jul 13.
- Maher CF, Yeung E, Chen Z, Masel A, Smith D, Lourie R, Devan SM, Rasch R, Uwins P, Blakey I, Boyle GM, Jones L. Pathogenesis of polypropylene mesh complications in female pelvic floor surgery. Am J Obstet Gynecol. 2025 Oct;233(4):309.e1-309.e11. doi: 10.1016/j.ajog.2025.03.009. Epub 2025 Mar 10.
- Liang R, Knight K, Abramowitch S, Moalli PA. Exploring the basic science of prolapse meshes. Curr Opin Obstet Gynecol. 2016 Oct;28(5):413-9. doi: 10.1097/GCO.0000000000000313.
- Page AS, Cattani L, Pacquee S, Claerhout F, Callewaert G, Housmans S, Van der Aa F, D'Hoore A, Deprest J. Long-term Data on Graft-Related Complications After Sacrocolpopexy With Lightweight Compared With Heavier-Weight Mesh. Obstet Gynecol. 2023 Jan 1;141(1):189-198. doi: 10.1097/AOG.0000000000005021. Epub 2022 Nov 30.
- Hofmann N, Rennekampff HO, Salz AK, Borgel M. Preparation of human amniotic membrane for transplantation in different application areas. Front Transplant. 2023 May 5;2:1152068. doi: 10.3389/frtra.2023.1152068. eCollection 2023.
- Jahanafrooz Z, Bakhshandeh B, Behnam Abdollahi S, Seyedjafari E. Human amniotic membrane as a multifunctional biomaterial: recent advances and applications. J Biomater Appl. 2023 Mar;37(8):1341-1354. doi: 10.1177/08853282221137609. Epub 2022 Nov 4.
- Giusto LL, Zahner PM, Goldman HB. Management of the Exposed or Perforated Midurethral Sling. Urol Clin North Am. 2019 Feb;46(1):31-40. doi: 10.1016/j.ucl.2018.08.003.
- Mao J, Chughtai B, Ibrahim S, Sedrakyan A. Food and Drug Administration Safety Communication on the Use of Transvaginal Mesh in Pelvic Organ Prolapse Repair Surgery: The Impact of Social Determinants of Health. Female Pelvic Med Reconstr Surg. 2021 Jan 1;27(1):e133-e138. doi: 10.1097/SPV.0000000000000863.
- Guler Sonmez T, Ugras E, Gul Sahin E, Fidanci I, Aksoy H, Ayhan Baser D. The prevalence of incontinence and its impact on quality of life. Medicine (Baltimore). 2024 Dec 27;103(52):e41108. doi: 10.1097/MD.0000000000041108.
- de Tayrac R, Antosh DD, Baessler K, Cheon C, Deffieux X, Gutman R, Lee J, Nager C, Schizas A, Sung V, Maher C. Summary: 2021 International Consultation on Incontinence Evidence-Based Surgical Pathway for Pelvic Organ Prolapse. J Clin Med. 2022 Oct 17;11(20):6106. doi: 10.3390/jcm11206106.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Hypothalamic Hormones
- Peptide Hormones
- Neuropeptides
- Peptides
- Amino Acids, Peptides, and Proteins
- Nerve Tissue Proteins
- Proteins
- Pituitary Hormones
- Pituitary Hormones, Anterior
- Melanocortins
- Pro-Opiomelanocortin
- Melanocyte-Stimulating Hormones
Other Study ID Numbers
Other Study ID Numbers
- 18099
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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