Vaginal Mesh Surgery Versus Robotic-assisted Abdominal Mesh Surgery in the Treatment of Apical Prolapse - Prospective Randomized Non-inferiority Study

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age18+
SponsorUniversity of Sao Paulo General Hospital

About this trial

The goal of this study is to compare vaginal mesh surgery with abdominal robotic-assisted mesh surgery for the treatment of genital prolapse in women. The main questions it seeks to answer are:

* Is the objective cure rate for vaginal mesh surgery non-inferior to that of the abdominal approach? * Is the use of vaginal mesh as safe as abdominal mesh?

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

The study will include patients diagnosed with apical compartment genital prolapse of stage II or higher, who have an indication for surgical correction.

Disqualifiers

The following exclusion criteria will apply: patients who are unable or unwilling to complete validated outcome assessment instruments; those requiring concomitant surgical procedures (e.g., hysterectomy or any other intervention that may alter pelvic floor anatomy);

individuals with a prior history of pelvic radiotherapy;

patients with congenital or acquired anomalies of the urogenital or gastrointestinal systems;

and those with medical conditions that constitute a contraindication to elective surgical intervention.

Trial design

Design model

Sequential

Treatments tested in this trial

  • Vaginal mesh surgery for apical prolapse

    Procedure/Surgery

    Cirurgia com tela vaginal para prolapso apical.

  • Robotic-assisted abdominal mesh surgery with Upsylon device (Boston Scientific - USA) for vaginal apical prolapse

    Procedure/Surgery

    Cirurgia robótica assistida por tela abdominal com dispositivo Upsylon (Boston Scientific - EUA) para prolapso apical vaginal.

Treatment groups

86 Participants
are divided into 2 treatment groups
Group A: Vaginal mesh surgeryExperimental treatment 1 intervention
Group B: Robotic-assited abdominal sacrocolpopexyActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Objective Cure Rate

The criteria for objective cure will be defined according to the Pelvic Organ Prolapse Quantification (POP-Q) system, with point C positioned at -6 cm or higher (proximal), corresponding to stage 0 or I genital prolapse.

Time frame
Patients will undergo evaluations at 1 month postoperatively and subsequently at 6-month intervals from the date of surgery, continuing until 24 months of follow-up have been completed.

Secondary outcomes

1

Surgical complication

Complications will be evaluated in the perioperative period and during follow-up, encompassing surgical complications, long-term adverse events such as mesh erosion, and complications necessitating corrective interventions. These complications will be categorized according to the Clavien-Dindo classification system.

Time frame
Patients will undergo evaluations at 1 month postoperatively and subsequently at 6-month intervals from the date of surgery, continuing until 24 months of follow-up have been completed.

Other outcomes

Sponsors and contacts

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