- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01762384
Laparoscopic Sacral Colpopexy Versus Modified Total Pelvic Floor Reconstructive Surgery for Apical Prolapse Stage III-IV
Nationwide Multicenter Randomized Prospective Study to Compare Laparoscopic Sacral Colpopexy and Modified Total Pelvic Floor Reconstructive Surgery With Mesh for Apical Prolapse Stage III-IV
Pelvic Organ prolapse (a feeling of bulge in the vagina) may cause some distressing symptoms such as loss of control of the bowel or bladder, and may also cause problems with patient's sex life. The primary treatment is surgery. Sacral Colpopexy is the gold standard procedure. Now it could be done laparoscopically. Modified total pelvic floor reconstructive surgery with mesh is developed in China for Asian Women.
This study is designed to determine the effectiveness and safety of Modified total pelvic floor reconstructive surgery with mesh compared with laparoscopic Sacral Colpopexy for the treatment of uterine or vault prolapse Stage III-IV.
Patients enrolled into the study will be followed up for up to 3 years after surgery. Evaluation will take place during surgery and postoperative visit. Stage of prolapse before and after surgery, patient satisfaction through quality of life and sexual function questionnaires before and after surgery, and peri-operative complication rates will be evaluated.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Pelvic organ prolapse is a common problem. The high rate of failure has led to an increasing use of synthetic grafts to augment vaginal repair procedures to obtain more durable results. In 2005, the investigators began to perform modified pelvic floor reconstruction surgery with mesh. The nation-wide multicenter prospective clinical trial data showed that it was safe, efficient and cost-effective. No severe intraoperative complications were recorded and the recurrence rate after 1 year follow-up was 8.1%. Quality of life improved significantly from the baseline, while the sexual function did not change.
Sacral colpopexy has long been regarded as the gold standard. Laparoscopic sacral colpopexy could offer durable result and low morbidity compared with open procedure.
In clinical practice, many women have symptomatic POP-Q Stage III-IV uterine or vault prolapse, which requires surgical correction. The aim of this multicenter, prospective and randomized study is to evaluate the effectiveness and safety of these two procedures in the treatment of symptomatic apical prolapse Stage III-IV in China.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Juan Chen
- Phone Number: 86-13521354364
- Email: pumchcj@sina.com
Study Contact Backup
- Name: Lan Zhu
- Phone Number: 86-13911714696
- Email: zhu_julie@sina.com
Study Locations
-
-
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Beijing, China, 100730
- Recruiting
- Peking Union Medical College Hospital
-
Contact:
- Lan Zhu
- Phone Number: 86-13911714696
-
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Guangdong
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Ghuangzhou, Guangdong, China, 510120
- Recruiting
- The First Affiliated Hospital of Guangzhou Medical College
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Contact:
- Xiaowei Zhang
- Phone Number: 86-13609086710
- Email: xwzhang81341235@163.com
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Henan
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Zhengzhou, Henan, China, 450052
- Recruiting
- The First Affiliated Hospital of Zhengzhou University
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Contact:
- Mei Ji
- Email: jimei0821@yahoo.com.cn
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Zhejiang
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Hangzhou, Zhejiang, China, 310006
- Recruiting
- Women's Hospital School of Medicine Zhejiang University
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Contact:
- Hangmei Jin
- Email: jinhm@zju.edu.cn
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Candidates with symptomatic uterine or vault prolapse of Stage III-IV, suitable for surgical repair.
- Age from 55-65 years old.
- Agrees to participate in the study, including completion of all study-related procedures, evaluations and questionnaires.
Exclusion Criteria:
- Patients who could not tolerate laparoscopic surgery.
- Previous repair of pelvic organ prolapse involving insertion of mesh.
- Experimental drug or experimental medical device within 3 months prior to the planned procedure.
- Active genital, urinary or systemic infection at the time of the surgical procedure. Surgery may be delayed in such subjects until the infection is cleared.
- Coagulation disorder or on therapeutic anticoagulant therapy at the time of surgery.
- History of chemotherapy or pelvic radiation therapy. Systemic disease known to affect bladder or bowel function (e.g. Parkinson's disease, multiple sclerosis, spinal cord injury or trauma).
- Current evaluation or treatment for chronic pelvic pain (e.g. interstitial cystitis, endometriosis, coccydynia, vulvodynia).
- Nursing or pregnant or intends future pregnancy.
- Chronic cough not well-controlled.
- BMI ≥ 30.
- In the investigator's opinion, any medical condition or psychiatric illness that could potentially be life threatening or affect their ability to complete the study visits according to this protocol.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: LSC
procedure: laparoscopic sacral colpopexy.
|
subjects of this group are submitted to surgical treatment of laparoscopic sacral colpopexy.
Both surgeries will be conducted using mesh constructed from polypropylene mesh.
|
Active Comparator: Modified PFRS
procedure: modified pelvic floor reconstructive surgery with mesh.
|
Both surgeries will be conducted using mesh constructed from polypropylene mesh.
subjects of this group are submitted to modified pelvic floor reconstructive surgery with mesh.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
anatomical improvement according to POP-Q score
Time Frame: 6 months
|
6 months
|
Anatomical improvement according to POP-Q Score
Time Frame: 1 year
|
1 year
|
Anatomical improvement according to POP-Q Score
Time Frame: 2 years
|
2 years
|
Anatomical improvement according to POP-Q Score
Time Frame: 3 years
|
3 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hospital data:operative time
Time Frame: At discharge, an expected average of 5 days after operation.
|
At discharge, an expected average of 5 days after operation.
|
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Presence/absence of complications (composite score).
Time Frame: up to 6 weeks
|
The occurrence (in the per-operative phase or within 6 weeks post-op) of at least one of the following: 1) bleeding complications; 2) infectious complications; 3) any wound caused by a surgeon movement: bladder, ureteral, or vascular injuries; 4)medical complications: deep vein thrombosis, pulmonary embolism and etc.Complications will be categorized using the Dindo surgical complication grading scale.
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up to 6 weeks
|
Change from baseline in PFIQ-7 scores.
Time Frame: 6 months, 1 year, 2 year, 3 year
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6 months, 1 year, 2 year, 3 year
|
|
Change from baseline in PFDI-21 scores.
Time Frame: 6 months, 1 year, 2 year, 3 year
|
6 months, 1 year, 2 year, 3 year
|
|
In subjects sexually active at baseline, assessment of sexual function using PISQ-12 (mean scores and change from baseline)
Time Frame: 6 months, 1 year, 2 year, 3 year
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6 months, 1 year, 2 year, 3 year
|
|
Subject global impression assessed on a 5 point Likert scale
Time Frame: 6 months, 1 year, 2 year, 3 year
|
6 months, 1 year, 2 year, 3 year
|
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Presence/absence of complications (composite score)
Time Frame: up to 3 years
|
Long-term negative outcomes of the surgical procedure will also be recorded until 3 years after surgery.
For example, mesh erosion, de novo urinary incontinence, de novo dyspareunia and overall failure rate.
Complications will be categorized using the Dindo surgical complication grading scale.
|
up to 3 years
|
hospital data: estimated blood loss
Time Frame: At discharge, an expected average of 5 days after operation.
|
At discharge, an expected average of 5 days after operation.
|
|
hospital data:length of stay
Time Frame: At discharge, an expected average of 5 days after operation.
|
At discharge, an expected average of 5 days after operation.
|
|
hospital data: postoperative morbidity
Time Frame: At discharge, an expected average of 5 days after operation.
|
At discharge, an expected average of 5 days after operation.
|
|
hospital data: time to recovery
Time Frame: At discharge, an expected average of 5 days after operation.
|
At discharge, an expected average of 5 days after operation.
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- pumch-gyn-05
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