C Emi Bretschneider1, Kimberly Kenton2, Elizabeth J Geller3, Jennifer M Wu3, Catherine A Matthews4. 1. Northwestern Feinstein School of Medicine, 250 E. Superior St. Suite 5-2370, Chicago, IL, 60611, USA. carol.bretschneider@nm.org. 2. Northwestern Feinstein School of Medicine, 250 E. Superior St. Suite 5-2370, Chicago, IL, 60611, USA. 3. Departments of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Urology, Wake Forest Baptist Health, Winston Salem, NC, USA.
Abstract
OBJECTIVES: The objective was to evaluate pain and dyspareunia in women undergoing minimally invasive total hysterectomy andsacrocolpopexy (TLH + SCP) with a light-weight polypropylene mesh 1 year after surgery. METHODS: This is a planned secondary analysis of a randomized trial comparing permanent (Gore-Tex) versus absorbable suture (PDS) for vaginal attachment of a y-mesh (Upsylon™) during TLH + SCP in women with stage ≥II prolapse. Patient data were collected at baseline and 1 year after surgery. Our primary outcome was patient-reported pain or dyspareunia at 1 year. RESULTS:Two hundred subjects (Gore-Tex n = 99, PDS n = 101) were randomized and underwent surgery. Overall, the mean age ± SD was 60 ± 10 years, and BMI was 27 ± 5 kg/m2. The majority were white (89%), menopausal (77%), and had stage III/IV (63%) prolapse. 93% completed a 1-year follow-up and are included in this analysis (Gor-Tex n = 95, PDS n = 90). The overall rate of participants who reported pain at 1 year was 20%. Of those who did not report any pain at baseline, 23% reported de novo dyspareunia, 4% reported de novo pain, and 3% reported both at 1 year. Of participants who reported pain or dyspareunia at baseline prior to surgery, 66% reported resolution of their symptoms at 1 year. There were no differences in most characteristics, including mesh/suture exposure (7% vs 5%, p = 0.56) between patients who did and did not report any pain at 1 year. On multiple logistic regression controlling for age, baseline dyspareunia, and baseline pain, baseline dyspareunia was associated with a nearly 4-fold increased odds of reporting any pain at 1 year (OR 3.8, 95%CI 1.7-8.9). CONCLUSIONS: The majority of women report resolution of pain 1 year following TLH + SCP with a low rate of de novo pain.
RCT Entities:
OBJECTIVES: The objective was to evaluate pain and dyspareunia in women undergoing minimally invasive total hysterectomy and sacrocolpopexy (TLH + SCP) with a light-weight polypropylene mesh 1 year after surgery. METHODS: This is a planned secondary analysis of a randomized trial comparing permanent (Gore-Tex) versus absorbable suture (PDS) for vaginal attachment of a y-mesh (Upsylon™) during TLH + SCP in women with stage ≥II prolapse. Patient data were collected at baseline and 1 year after surgery. Our primary outcome was patient-reported pain or dyspareunia at 1 year. RESULTS: Two hundred subjects (Gore-Tex n = 99, PDS n = 101) were randomized and underwent surgery. Overall, the mean age ± SD was 60 ± 10 years, and BMI was 27 ± 5 kg/m2. The majority were white (89%), menopausal (77%), and had stage III/IV (63%) prolapse. 93% completed a 1-year follow-up and are included in this analysis (Gor-Tex n = 95, PDS n = 90). The overall rate of participants who reported pain at 1 year was 20%. Of those who did not report any pain at baseline, 23% reported de novo dyspareunia, 4% reported de novo pain, and 3% reported both at 1 year. Of participants who reported pain or dyspareunia at baseline prior to surgery, 66% reported resolution of their symptoms at 1 year. There were no differences in most characteristics, including mesh/suture exposure (7% vs 5%, p = 0.56) between patients who did and did not report any pain at 1 year. On multiple logistic regression controlling for age, baseline dyspareunia, and baseline pain, baseline dyspareunia was associated with a nearly 4-fold increased odds of reporting any pain at 1 year (OR 3.8, 95%CI 1.7-8.9). CONCLUSIONS: The majority of women report resolution of pain 1 year following TLH + SCP with a low rate of de novo pain.
Authors: Kimberly Kenton; Elizabeth R Mueller; Christopher Tarney; Catherine Bresee; Jennifer T Anger Journal: Female Pelvic Med Reconstr Surg Date: 2016 Sep-Oct Impact factor: 2.091
Authors: Catherine A Matthews; Elizabeth J Geller; Barbara R Henley; Kimberly Kenton; Erinn M Myers; Alexis A Dieter; Brent Parnell; Christina Lewicky-Gaupp; Margaret G Mueller; Jennifer M Wu Journal: Obstet Gynecol Date: 2020-08 Impact factor: 7.661
Authors: J Eric Jelovsek; Matthew D Barber; Linda Brubaker; Peggy Norton; Marie Gantz; Holly E Richter; Alison Weidner; Shawn Menefee; Joseph Schaffer; Norma Pugh; Susan Meikle Journal: JAMA Date: 2018-04-17 Impact factor: 56.272
Authors: Marie Fidela R Paraiso; J Eric Jelovsek; Anna Frick; Chi Chung Grace Chen; Matthew D Barber Journal: Obstet Gynecol Date: 2011-11 Impact factor: 7.661
Authors: Jennifer T Anger; Elizabeth R Mueller; Christopher Tarnay; Bridget Smith; Kevin Stroupe; Amy Rosenman; Linda Brubaker; Catherine Bresee; Kimberly Kenton Journal: Obstet Gynecol Date: 2014-01 Impact factor: 7.661
Authors: Anne-Lotte W M Coolen; Anique M J van Oudheusden; Ben Willem J Mol; Hugo W F van Eijndhoven; Jan-Paul W R Roovers; Marlies Y Bongers Journal: Int Urogynecol J Date: 2017-04-17 Impact factor: 2.894
Authors: Patrick J Culligan; Emil Gurshumov; Christa Lewis; Jennifer L Priestley; Jodie Komar; Nihar Shah; Charbel G Salamon Journal: Int Urogynecol J Date: 2013-11-22 Impact factor: 2.894