Unrecognized ConditionNCT03445442
Different Surgical Techniques Used for Prolapse Repair in Elderly Patient
An observational study of Unrecognized Condition, run by Centre Hospitalier Universitaire de Nice.
Trial summary
The investigator aimed to compare various pelvic floor repairs in female aged from 70 to 80 years old, to see which procedure in terms of treatment-related complications of SCP, VMR and NTR by comparing the operative and functional outcomes in this patient population. Read more about this study
- Who is it for?
- Ages 70 to 80 years, women only
- Conditions the study is for
- Unrecognized Condition
- What is being tested?
- SCP, NTR and VMR
- Type of treatment
- Surgery or procedure
- How many people
- 214 participants
- Where
- No sites listed yet
- Study dates
- 1 Jan 2011to 5 Apr 2017
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 70 to 80 years
- Women only
- No healthy volunteers
- Older adult
Study population: The study cohort is selected from our institution. The study involves elderly females over 70 years old with advanced pelvic organ prolapse.
Who may be able to join
- Patients with a pelvic organ prolapse
- Patients aged between 70 and 80 years old
- Patients with symptomatic anterior, apical and/or posterior compartment prolapse, stage 2 or greater
Who cannot join
- Patients with a previous history of pelvic surgery for a cancer diagnosis are excluded
- Patients with a surgical repair specific to the existing defect site (For group 2)
About this study
The investigator aimed to compare various pelvic floor repairs in female aged from 70 to 80 years old, to see which procedure in terms of treatment-related complications of SCP, VMR and NTR by comparing the operative and functional outcomes in this patient population.
Read the detailed description
Pelvic organ prolapse (POP) is a global health care issue that could have a significant impact on pelvic floor function and quality of life (QOL), while seldom having the potential to be life-threatening. Prevalence of POP increases with age. In women older than 80, 11% undergo a surgical procedure. The incidence of degenerative diseases and multiple co-morbidities increases with age, and advanced age is also associated with an increase in morbidity generally for gynecologic procedures. Furthermore, greater comorbidity beforehand can predispose patients to postoperative complications such as bleeding, hematoma, pain, infectious. As a result hospital stays are longer and the surgical results are compromised.
Surgical techniques should optimize functional results and minimize complications. In POP surgery, younger women are good candidates for sacrocolpopexy (SCP), because of the improved long term functional result, while women older than 80 may have a satisfactory outcome with fewer complication with a vaginal repair with mesh (VMR) or native tissue (NTR). The increasing prevalence of POP, and the increasing population of women aged 70-80 requires an evaluation of the appropriate surgical management since women in this age group may be candidates for all types of surgical repair.
- Conditions
- Unrecognized Condition
- Being tested
- SCP, NTR, VMR
- Keywords
- Elderly, Native tissue repair, Pelvic Organ Prolapse, Sacrocolpopexy, Vaginal mesh repair
- Medical subject headings
- Pelvic Organ Prolapse
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SCPProcedure or surgery
Sacrocolpopexy (SCP) aims to secure the anterior vaginal wall, the uterus more or less the posterior vaginal wall using polypropylene prostheses and to secure them to the presacral ligament to restore the patient's anatomical features and improve pelvic symptoms
NTRProcedure or surgery
Native tissue repair surgery (NTR) consist of site-specific surgical repair of the existing defect (anterior and/or posterior) using non-absorbable sutures. Specifically, anterior and/or posterior colporrhaphy for cystocele and rectocele respectively after adequate hydrodissection of the vesicovaginal or rectovaginal space.
VMRProcedure or surgery
Vaginal mesh repair surgery (VMR) is performed using a single-incision mesh system. A single vertical incision is made in the anterior and/or posterior vaginal wall. A full-thickness dissection is performed laterally and apically to the ischial spine.
| Study group | Role | What they receive |
|---|---|---|
| Group 1 | Sacrocolpopexy (SCP) Receives: Procedure: SCP | |
| Group 2 | Native tissue repair surgery (NTR) Receives: Procedure: NTR | |
| Group 3 | Vaginal mesh repair surgery (VMR) Receives: Procedure: VMR |
What is being measured
The primary outcome is the main question the study is designed to answer.
Post-operative complications
All complications are recorded, corresponding to Clavien Dindo classification.
Measured: 12 months follow-up
Secondary outcomes (2)
Anatomical success rate
Assessed by recovery time and anatomical correction
Measured: 12 months follow-up
Surgical satisfaction
Assessed by the validated Surgical Satisfaction Questionnaire (SSQ-8)
Measured: 12 months follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Feb 2018
- Study start1 Jan 2011
- Primary completion1 Dec 2012
- Study completion5 Apr 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (29)Papers the sponsor has linked to this study.
- Other trials for Unrecognized ConditionStudies of the same condition, open and under way.
- More trials run by Centre Hospitalier Universitaire de NiceThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 214 participants (actual)
Sponsor and investigators
- Lead sponsor
- Centre Hospitalier Universitaire de Nice
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03445442
- Sponsor's protocol ID
- URO-BASE02
- Status last verified
- Feb 2018
- First submitted
- 12 Feb 2018
- Last updated
- 22 Mar 2018
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: CFU, Publication at the European Journal in February 2018
Publications
Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 1999 Feb;180(2 Pt 1):299-305. doi: 10.1016/s0002-9378(99)70203-6.
PubMed 9988790Gomelsky A, Penson DF, Dmochowski RR. Pelvic organ prolapse (POP) surgery: the evidence for the repairs. BJU Int. 2011 Jun;107(11):1704-19. doi: 10.1111/j.1464-410X.2011.10123.x.
PubMed 21592280Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA. 1995 Jul 5;274(1):44-50.
PubMed 7791257Luber KM, Boero S, Choe JY. The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynecol. 2001 Jun;184(7):1496-501; discussion 1501-3. doi: 10.1067/mob.2001.114868.
PubMed 11408873Stepp KJ, Barber MD, Yoo EH, Whiteside JL, Paraiso MF, Walters MD. Incidence of perioperative complications of urogynecologic surgery in elderly women. Am J Obstet Gynecol. 2005 May;192(5):1630-6. doi: 10.1016/j.ajog.2004.11.026.
PubMed 15902169Tabata T, Yamawaki T, Ida M, Nishimura K, Nose Y, Yabana T. Clinical value of dilatation and curettage for abnormal uterine bleeding. Arch Gynecol Obstet. 2001 Jan;264(4):174-6. doi: 10.1007/s004040000100.
PubMed 11205702Hornemann A, Kamischke A, Luedders DW, Beyer DA, Diedrich K, Bohlmann MK. Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women. Arch Gynecol Obstet. 2010 Jan;281(1):59-64. doi: 10.1007/s00404-009-1063-7. Epub 2009 Mar 31.
PubMed 19333610Sabbagh R, Mandron E, Piussan J, Brychaert PE, Tu le M. Long-term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse. BJU Int. 2010 Sep;106(6):861-6. doi: 10.1111/j.1464-410X.2009.09173.x. Epub 2010 Jan 19.
PubMed 20089111Gerten KA, Markland AD, Lloyd LK, Richter HE. Prolapse and incontinence surgery in older women. J Urol. 2008 Jun;179(6):2111-8. doi: 10.1016/j.juro.2008.01.089.
PubMed 18423726Visco AG, Wei JT, McClure LA, Handa VL, Nygaard IE; Pelvic Floor Disorders Network. Effects of examination technique modifications on pelvic organ prolapse quantification (POP-Q) results. Int Urogynecol J Pelvic Floor Dysfunct. 2003 Jun;14(2):136-40. doi: 10.1007/s00192-002-1030-3. Epub 2003 Mar 28.
PubMed 12851759Giuly J, Cravello L, D'Ercole C, Roger V, Porcu G, Blanc B. [Richter's spinofixation in vaginal prolapse]. Chirurgie. 1997;122(7):430-4. French.
PubMed 9588065Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae.
PubMed 15273542Murphy M, Sternschuss G, Haff R, van Raalte H, Saltz S, Lucente V. Quality of life and surgical satisfaction after vaginal reconstructive vs obliterative surgery for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2008 May;198(5):573.e1-7. doi: 10.1016/j.ajog.2007.12.036.
PubMed 18455537King SW, Jefferis H, Jackson S, Marfin AG, Price N. Laparoscopic uterovaginal prolapse surgery in the elderly: feasibility and outcomes. Gynecol Surg. 2017;14(1):2. doi: 10.1186/s10397-017-1000-x. Epub 2017 Apr 11.
PubMed 28479877Sung VW, Weitzen S, Sokol ER, Rardin CR, Myers DL. Effect of patient age on increasing morbidity and mortality following urogynecologic surgery. Am J Obstet Gynecol. 2006 May;194(5):1411-7. doi: 10.1016/j.ajog.2006.01.050.
PubMed 16647926
Study at a glance
From the registry record, last updated by the sponsor on 22 Mar 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Different Surgical Techniques Used for Prolapse Repair in Elderly Patient
- ClinicalTrials.gov ID
- NCT03445442
- Acronym / sponsor ID
- URO-BASE02
- Conditions
- Unrecognized Condition
- Keywords
- Elderly, Native tissue repair, Pelvic Organ Prolapse, Sacrocolpopexy, Vaginal mesh repair
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 214 participants (actual)
- Lead sponsor
- Centre Hospitalier Universitaire de NiceUniversity, hospital or other
- Study start
- 1 Jan 2011 (actual)
- Primary completion
- 1 Dec 2012 (actual)
- Study completion
- 5 Apr 2017 (actual)
- First posted
- 26 Feb 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigator aimed to compare various pelvic floor repairs in female aged from 70 to 80 years old, to see which procedure in terms of treatment-related complications of SCP, VMR and NTR by comparing the operative and functional outcomes in this patient population.
Detailed description
Pelvic organ prolapse (POP) is a global health care issue that could have a significant impact on pelvic floor function and quality of life (QOL), while seldom having the potential to be life-threatening. Prevalence of POP increases with age. In women older than 80, 11% undergo a surgical procedure. The incidence of degenerative diseases and multiple co-morbidities increases with age, and advanced age is also associated with an increase in morbidity generally for gynecologic procedures. Furthermore, greater comorbidity beforehand can predispose patients to postoperative complications such as bleeding, hematoma, pain, infectious. As a result hospital stays are longer and the surgical results are compromised.
Surgical techniques should optimize functional results and minimize complications. In POP surgery, younger women are good candidates for sacrocolpopexy (SCP), because of the improved long term functional result, while women older than 80 may have a satisfactory outcome with fewer complication with a vaginal repair with mesh (VMR) or native tissue (NTR). The increasing prevalence of POP, and the increasing population of women aged 70-80 requires an evaluation of the appropriate surgical management since women in this age group may be candidates for all types of surgical repair.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Group 1 | – | Procedure: SCPSacrocolpopexy (SCP) |
| Group 2 | – | Procedure: NTRNative tissue repair surgery (NTR) |
| Group 3 | – | Procedure: VMRVaginal mesh repair surgery (VMR) |
Who may qualify
- Ages
- 70 to 80 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
- Study population
- The study cohort is selected from our institution. The study involves elderly females over 70 years old with advanced pelvic organ prolapse.
Key inclusion criteria (3 listed)
- Patients with a pelvic organ prolapse
- Patients aged between 70 and 80 years old
- Patients with symptomatic anterior, apical and/or posterior compartment prolapse, stage 2 or greater
Key exclusion criteria (2 listed)
- Patients with a previous history of pelvic surgery for a cancer diagnosis are excluded
- Patients with a surgical repair specific to the existing defect site (For group 2)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SCPSacrocolpopexy (SCP) aims to secure the anterior vaginal wall, the uterus more or less the posterior vaginal wall using polypropylene prostheses and to secure them to the presacral ligament to restore the patient's anatomical features and improve pelvic symptoms | Procedure or surgery | Group 1 |
| NTRNative tissue repair surgery (NTR) consist of site-specific surgical repair of the existing defect (anterior and/or posterior) using non-absorbable sutures. Specifically, anterior and/or posterior colporrhaphy for cystocele and rectocele respectively after adequate hydrodissection of the vesicovaginal or rectovaginal space. | Procedure or surgery | Group 2 |
| VMRVaginal mesh repair surgery (VMR) is performed using a single-incision mesh system. A single vertical incision is made in the anterior and/or posterior vaginal wall. A full-thickness dissection is performed laterally and apically to the ischial spine. | Procedure or surgery | Group 3 |
Primary outcome
Post-operative complications
Time frame: 12 months follow-up
All complications are recorded, corresponding to Clavien Dindo classification.
2 secondary outcomes
Anatomical success rate
Time frame: 12 months follow-up
Surgical satisfaction
Time frame: 12 months follow-up
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Mar 2018.
- Background: PubMed 9988790Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 1999 Feb;180(2 Pt 1):299-305. doi: 10.1016/s0002-9378(99)70203-6.
- Background: PubMed 21592280Gomelsky A, Penson DF, Dmochowski RR. Pelvic organ prolapse (POP) surgery: the evidence for the repairs. BJU Int. 2011 Jun;107(11):1704-19. doi: 10.1111/j.1464-410X.2011.10123.x.
- Background: PubMed 7791257Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA. 1995 Jul 5;274(1):44-50.
- Background: PubMed 11408873Luber KM, Boero S, Choe JY. The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynecol. 2001 Jun;184(7):1496-501; discussion 1501-3. doi: 10.1067/mob.2001.114868.
- Background: PubMed 15902169Stepp KJ, Barber MD, Yoo EH, Whiteside JL, Paraiso MF, Walters MD. Incidence of perioperative complications of urogynecologic surgery in elderly women. Am J Obstet Gynecol. 2005 May;192(5):1630-6. doi: 10.1016/j.ajog.2004.11.026.
- Background: PubMed 11205702Tabata T, Yamawaki T, Ida M, Nishimura K, Nose Y, Yabana T. Clinical value of dilatation and curettage for abnormal uterine bleeding. Arch Gynecol Obstet. 2001 Jan;264(4):174-6. doi: 10.1007/s004040000100.
- Background: PubMed 19333610Hornemann A, Kamischke A, Luedders DW, Beyer DA, Diedrich K, Bohlmann MK. Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women. Arch Gynecol Obstet. 2010 Jan;281(1):59-64. doi: 10.1007/s00404-009-1063-7. Epub 2009 Mar 31.
- Background: PubMed 20089111Sabbagh R, Mandron E, Piussan J, Brychaert PE, Tu le M. Long-term anatomical and functional results of laparoscopic promontofixation for pelvic organ prolapse. BJU Int. 2010 Sep;106(6):861-6. doi: 10.1111/j.1464-410X.2009.09173.x. Epub 2010 Jan 19.
- Background: PubMed 18423726Gerten KA, Markland AD, Lloyd LK, Richter HE. Prolapse and incontinence surgery in older women. J Urol. 2008 Jun;179(6):2111-8. doi: 10.1016/j.juro.2008.01.089.
- Background: PubMed 12851759Visco AG, Wei JT, McClure LA, Handa VL, Nygaard IE; Pelvic Floor Disorders Network. Effects of examination technique modifications on pelvic organ prolapse quantification (POP-Q) results. Int Urogynecol J Pelvic Floor Dysfunct. 2003 Jun;14(2):136-40. doi: 10.1007/s00192-002-1030-3. Epub 2003 Mar 28.
- Background: PubMed 9588065Giuly J, Cravello L, D'Ercole C, Roger V, Porcu G, Blanc B. [Richter's spinofixation in vaginal prolapse]. Chirurgie. 1997;122(7):430-4. French.
- Background: PubMed 15273542Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae.
- Individual participant dataSharing planned: No. CFU, Publication at the European Journal in February 2018
Related trials for Unrecognized Condition
Recruiting
Effects of a Specialized Diabetes and Heart Clinic and Detection of Unrecognized Heart Failure in People With Type 2 Diabetes and Cardiovascular Disease
Cardiovascular Disease, Cardiometabolic Diseases
Enrolling by invitationObservational study
RNA to the RESCUE: Evaluation to Assess the Clinical Utility of RNA Sequencing in Establishing a Genetic Diagnosis or Adjudicating a Previously Established Genetic Diagnosis.
Genetic Conditions, Genetic Disorders
RecruitingObservational study
Determination of the Prevalence of Unrecognized Heart Failure Among Patients at Risk in Urban Areas Across Germany Using CMR
Heart Failure With Preserved Ejection Fraction (HFPEF), Renal Dysfunction
RecruitingObservational study
Evaluate DF-003 in ex Vivo Assays Using Peripheral Blood Mononuclear Cell From Subjects With ROSAH Syndrome
Unrecognized Condition
Recruiting
Effects of LH and FSH on Metabolic Regulation in Cumulus Cells
Unrecognized Condition
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of Unrecognized Condition, run by Centre Hospitalier Universitaire de Nice.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Post-operative complications (time frame: 12 months follow-up). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03445442, which also lists 29 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Mar 2018.