AzTrials
AzTrials

Pelvic Organ ProlapseNCT05682989

Efficacy/Safety of Urogynecology Synthetic Mesh Surgery

An observational study of Pelvic Organ Prolapse and Stage III and IV High Grade Pelvic Organ Prolapse, run by Mackay Medical College at 1 site in Taiwan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This is a retrospective cohort study, aiming at analyzing the efficacy and safety of mesh surgery in pelvic organ prolapse. The synthetic mesh for pelvic organ prolapse include transvaginal mesh or laparotomy, laparoscope, or robotic-assisted laparoscopic sacrocolpopexy with mesh augmentation. Read more about this study

Who is it for?
Ages 30 to 100 years, women only
What is being tested?
Urodynamic investigations before and after a mesh surgery protocol., Urodynamic investigations before and after a robotic-assisted sacrocolpopexy protocol. and Urodynamic investigations before and after a hysterectomy with trans-vaginal mesh repair
How many people
150 participants
Where
1 siteTaiwan
Study dates
1 Aug 2022to 31 Dec 2027
Phase
Observational
Are there results?
Not yet: the study is under way

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 30 to 100 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Study population: History of POP patients with concurrent objective and/or subjective voiding dysfunctions who underwent primary TVM surgery for symptomatic POP ≥ stage II (POP Quantification system; POP-Q system) in Mackay Memorial Hospital were recruited.

Who may be able to join

  • Pelvic organ prolapse patients with objective / subjective voiding dysfunctions
  • Underwent surgery for symptomatic POP ≥ stage II (POP-Q system)

Who cannot join

  • Patients with a history of pelvic radiation.
  • Patients with a history of vesico-/recto-/urethra-vaginal fistula
  • Patients unable to be followed up.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Hui-Hsuan Lau, M.D. contact

+886-975-835928

huihsuan1220@gmail.com

Taiwan1 site, 1 recruiting
  • Department of Obstetrics and Gynecology

    New Taipei City

    Hui-Hsuan Lau, PhD, +886 975-835928, huihsuan1220@gmail.com

    Recruiting

Other trials in Taiwan

About this study

Official title: Evaluation of Efficacy and Safety of Urogynecology Synthetic Mesh Surgery in Women With Pelvic Organ Prolapse

This is a retrospective cohort study, aiming at analyzing the efficacy and safety of mesh surgery in pelvic organ prolapse. The synthetic mesh for pelvic organ prolapse include transvaginal mesh or laparotomy, laparoscope, or robotic-assisted laparoscopic sacrocolpopexy with mesh augmentation. The investigators would like to evaluate the efficacy and safety, such as recurrence rates and complication rates for women who underwent urogynecology mesh surgery.

Read the detailed description

Gynecologic mesh, including transvaginal mesh and mesh used in abdominal or laparoscopic sacrocolpopexy, has been used for pelvic organ prolapse since its debut in the US in 2005. It provides higher success and satisfaction rate than traditional colporrhaphy, but mesh-related complications, such as pain, mesh exposure and bleeding, have been reported. U.S. Food and Drug Administration issued a Safety Update in 2011 to inform the public that serious complications associated with synthetic mesh for the transvaginal repair of POP were common. Taiwan FDA and associated committees decided that the use of gynecologic mesh should be regulated. Thorough study and evaluation are needed.

Being tested
Urodynamic investigations before and after a mesh surgery protocol., Urodynamic investigations before and after a robotic-assisted sacrocolpopexy protocol., Urodynamic investigations before and after a hysterectomy with trans-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.

  • Urodynamic investigations before and after a mesh surgery protocol.Procedure or surgery

    Urodynamic investigations (The urodynamic study included free uroflowmetry, postvoid residual, filling and voiding cystometry, and a urethral pressure profile. The filling cystometry and urethral pressure profile were performed with 37 degrees C normal saline similar to body temperature at an infusion rate of 80 ml/min.

  • Urodynamic investigations before and after a robotic-assisted sacrocolpopexy protocol.Procedure or surgery

    All surgeries were performed using a DaVinci robotic system (Intuitive® Surgical Inc., Sunnyvale, California,US) with standardized technique and materials. Patients were positioned in dorsal lithotomy and steep Trendelenburg position. Trocars were placed bilaterally, and an assistant port was placed laterally. The peritoneum was opened medial to the ureter to develop an avascular space. The mesh was placed on the posterior and anterior vaginal wall and fixed at the level of anterior longitudinal ligaments S1/S2 by sutures. An intraoperative clinical examination was performed to ensure the mesh was in a tension-free position.

  • Urodynamic investigations before and after a hysterectomy with trans-vaginal mesh repairProcedure or surgery

    In summary, a vertical incision was made in the anterior vaginal wall to access the vesicovaginal space. The sacrospinous ligament was dissected, and an applicator was inserted and positioned over the SSL. The anchor was fixed to the SSL and the thread was attached to the mesh. The mesh was then adjusted in a tension-free manner, excess mesh was cut, and the incision was closed with suture.

Study groups in NCT05682989
Study groupRoleWhat they receive
mesh surgeryData obtained before the operation
Receives: Procedure: Urodynamic investigations before and after a mesh surgery protocol.
Robotic-assisted sacrocolpopexyData obtained before the operation
Receives: Procedure: Urodynamic investigations before and after a robotic-assisted sacrocolpopexy protocol.
a hysterectomy with trans-vaginal mesh repair (Surelift®, Neomedic International, Barcelona, Spain)Data obtained before the operation
Receives: Procedure: Urodynamic investigations before and after a hysterectomy with trans-vaginal mesh repair

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. trans-vaginal mesh repair

    Urodynamic investigations (The urodynamic study included free uroflowmetry, postvoid residual, filling and voiding cystometry, and a urethral pressure profile. The filling cystometry and urethral pressure profile were performed with 37 degrees C normal saline similar to body temperature at an infusion rate of 80 ml/min.

    1. The urodynamic data of POP patient with grade > or = II, will be retrograde analyzed and and compared.
    2. Pressure-associated parameters, such as abdominal pressure (Pabd), detrusor pressure (Pdet) will be measured as centimeter of water column (cmH2O), volume-associated parameters, such as infused volume (Vinf), voided volume (Vvod) and intravesical volume (Vive) will measured as ml. Derived parameter will be expressed as their results of calculation.

    Measured: Generally in our hospital, pre-operative investigation will be done about 30 days before surgery, post-operative investigation will within 1year after surgery.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jan 2023
  2. Study start1 Aug 2022
  3. Primary completion1 Aug 2023 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

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
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05682989
Sponsor's protocol ID
22MMHIS361e
Status last verified
Apr 2023
First submitted
28 Dec 2022
Last updated
5 Apr 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: For we uncertain if this might violate personal information laws in our country.

Publications

  • Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ; Members of Committees; Fourth International Consultation on Incontinence. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213-40. doi: 10.1002/nau.20870. No abstract available.

    PubMed 20025020
  • GREEN TH Jr. Development of a plan for the diagnosis and treatment of urinary stress incontinence. Am J Obstet Gynecol. 1962 Mar 1;83:632-48. doi: 10.1016/s0002-9378(16)35894-x. No abstract available.

    PubMed 13901453
  • McGuire EJ, Lytton B, Kohorn EI, Pepe V. The value of urodynamic testing in stress urinary incontinence. J Urol. 1980 Aug;124(2):256-8. doi: 10.1016/s0022-5347(17)55396-3.

    PubMed 7401242
  • Ulmsten U, Johnson P, Rezapour M. A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Br J Obstet Gynaecol. 1999 Apr;106(4):345-50. doi: 10.1111/j.1471-0528.1999.tb08272.x.

    PubMed 10426241
  • Fusco F, Abdel-Fattah M, Chapple CR, Creta M, La Falce S, Waltregny D, Novara G. Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence. Eur Urol. 2017 Oct;72(4):567-591. doi: 10.1016/j.eururo.2017.04.026. Epub 2017 May 4.

    PubMed 28479203
  • Jiao B, Lai S, Xu X, Zhang M, Diao T, Zhang G. A systematic review and meta-analysis of single-incision mini-slings (MiniArc) versus transobturator mid-urethral slings in surgical management of female stress urinary incontinence. Medicine (Baltimore). 2018 Apr;97(14):e0283. doi: 10.1097/MD.0000000000010283.

    PubMed 29620645
  • Stav K, Dwyer PL, Rosamilia A, Schierlitz L, Lim YN, Lee J. Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence. Int Urogynecol J. 2010 Feb;21(2):149-55. doi: 10.1007/s00192-009-1020-9. Epub 2009 Oct 24.

    PubMed 19855914
  • Ford AA, Ogah JA. Retropubic or transobturator mid-urethral slings for intrinsic sphincter deficiency-related stress urinary incontinence in women: a systematic review and meta-analysis. Int Urogynecol J. 2016 Jan;27(1):19-28. doi: 10.1007/s00192-015-2797-3. Epub 2015 Jul 29.

    PubMed 26220506
  • Sand PK, Bowen LW, Panganiban R, Ostergard DR. The low pressure urethra as a factor in failed retropubic urethropexy. Obstet Gynecol. 1987 Mar;69(3 Pt 1):399-402.

    PubMed 3822288
  • McGuire EJ, Fitzpatrick CC, Wan J, Bloom D, Sanvordenker J, Ritchey M, Gormley EA. Clinical assessment of urethral sphincter function. J Urol. 1993 Nov;150(5 Pt 1):1452-4. doi: 10.1016/s0022-5347(17)35806-8.

    PubMed 8411422
  • Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn. 1995;14(2):131-9. doi: 10.1002/nau.1930140206.

    PubMed 7780440
  • Kenton K, Stoddard AM, Zyczynski H, Albo M, Rickey L, Norton P, Wai C, Kraus SR, Sirls LT, Kusek JW, Litman HJ, Chang RP, Richter HE. 5-year longitudinal followup after retropubic and transobturator mid urethral slings. J Urol. 2015 Jan;193(1):203-10. doi: 10.1016/j.juro.2014.08.089. Epub 2014 Aug 23.

    PubMed 25158274
  • Foss Hansen M, Lose G, Kesmodel US, Gradel KO. Reoperation for urinary incontinence: a nationwide cohort study, 1998-2007. Am J Obstet Gynecol. 2016 Feb;214(2):263.e1-263.e8. doi: 10.1016/j.ajog.2015.08.069. Epub 2015 Sep 5.

    PubMed 26344752
  • Sun MJ, Chuang YL, Lau HH, Lo TS, Su TH. The efficacy and complications of using transvaginal mesh to treat pelvic organ prolapse in Taiwan: A 10-year review. Taiwan J Obstet Gynecol. 2021 Mar;60(2):187-192. doi: 10.1016/j.tjog.2021.01.031.

    PubMed 33678316
  • Lau HH, Lai CY, Hsieh MC, Peng HY, Chou D, Su TH, Lee JJ, Lin TB. Uneven effects of trans-vaginal mesh reconstruction on the viscoelastic property of the urinary bladder in patients with pelvic organ prolapse. Front Bioeng Biotechnol. 2026 Jan 12;13:1677779. doi: 10.3389/fbioe.2025.1677779. eCollection 2025.

    PubMed 41602457

Questions about this trial

What is this clinical trial studying?

An observational study of Pelvic Organ Prolapse and Stage III and IV High Grade Pelvic Organ Prolapse, run by Mackay Medical College at 1 site in Taiwan.

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 2 inclusion and 3 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: looking for participants now, as of the sponsor's last update on 5 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hui-Hsuan Lau, M.D. (+886-975-835928, huihsuan1220@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

trans-vaginal mesh repair (time frame: Generally in our hospital, pre-operative investigation will be done about 30 days before surgery, post-operative investigation will within 1year after surgery.). 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 NCT05682989, which also lists 17 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 5 Apr 2023.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in