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Traditional vs. Graft-augmented Posterior Colporrhaphy

This study has been terminated.
(Could not meet recruitment, technology advancement.)
Sponsor:
ClinicalTrials.gov Identifier:
NCT00581594
First Posted: December 27, 2007
Last Update Posted: August 6, 2010
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by:
University of California, Irvine
  Purpose
Women who undergo posterior colporrhaphy with graft augmentation will have a lower recurrence of their posterior wall defect than women who undergo a traditional posterior colporrhaphy.

Condition Intervention
Pelvic Organ Prolapse Posterior Vaginal Wall Defects Procedure: Graft-augmented colporrhaphy Procedure: Traditional posterior colporrhaphy

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Treatment
Official Title: Traditional vs. Graft-augmented Posterior Colporrhaphy: A Randomized Prospective Study

Resource links provided by NLM:


Further study details as provided by University of California, Irvine:

Primary Outcome Measures:
  • The primary outcome of recurrence of stage II posterior wall defects will be measured using the pelvic organ prolapse quantification exam (POPQ). [ Time Frame: 5 Years ]

Secondary Outcome Measures:
  • The secondary outcomes will be measuring the effects of the surgical repair on various aspects of life using a series of questionnaires: SF-36 as a measure of quality of life, PISQ to measure sexual function, and FISI to measure rectal function. [ Time Frame: 5 Years ]

Estimated Enrollment: 128
Study Start Date: January 2006
Estimated Study Completion Date: December 2011
Estimated Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1
Posterior repair with graft augmentation.
Procedure: Graft-augmented colporrhaphy
Patients will undergo randomized surgical procedure. Patients will be seen at 6 weeks for a pelvic exam and evaluation of the posterior wall. Points Ap and Bp will be recorded with values at 0.5cm intervals being on the posterior vaginal wall that is 3cm above the hymen. Point Bp is the most dependent portion of the posterior vaginal wall when the patient performs a Valsalva maneuver. Patients will be seen at 6 months for a pelvic exam evaluation of posterior wall support and completion of SF-36, PISQ and FISI. Patients will be given 60 minute Questionnaires on defecatory dysfunction, pelvic pain and/or symptoms of prolapse. Patients will be seen at 1 year and yearly intervals up to five years for a pelvic exam for evaluation of posterior wall support and the questionnaires.
Other Name: Xenform® material
2
Posterior repair without graft augmentation.
Procedure: Traditional posterior colporrhaphy
Patients will undergo randomized surgical procedure. Patients will be seen at 2 weeks for routine post-op care and evaluation of any post-op complications. Patients will be seen at 6 weeks for a pelvic exam and evaluation of the posterior wall. Points Ap and Bp will be recorded with values at 0.5cm intervals being on the posterior vaginal wall that is 3cm above the hymen. Point Bp is the most dependent portion of the posterior vaginal wall when the patient performs a Valsalva maneuver. Patients will be seen at 6 months, for a pelvic exam evaluation of posterior wall support and completion of SF-36, PISQ and FISI. Patients will be given 60 minute Questionnaires on defecatory dysfunction, pelvic pain and/or symptoms of prolapse. Patients will be seen at 1 year and yearly intervals up to five years to have a pelvic exam for evaluation of posterior wall support and the questionnaires.

Detailed Description:
The traditional approach to surgical repair of posterior wall defect is the posterior colporrhaphy. Although this technique has been successful in the anatomic correction of the defect, the functional outcomes have been disappointing. This fact suggests improvement in the functional and anatomic outcomes following a traditional posterior colporrhaphy. Consequently, the idea of incorporating graft material into the repair to augment the patient's own tissue has been examined. Placing a piece of graft material in between the vagina and rectum adds an extra layer of support and thus augments the strength of the repair. The purpose of this study is to evaluate the anatomic and functional outcomes of posterior compartment, graft-augmented traditional posterior colporrhaphy vs. traditional posterior colporrhaphy alone.
  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age > 18 years old
  • Posterior wall defect with point Ap or Bp at 0 or greater
  • Desires surgical correction
  • Willing to accept randomization to graft vs. no graft
  • Competent to sign an informed consent
  • Completed childbearing
  • Non-pregnant

Exclusion Criteria:

  • Current anal sphincter disruption with planned incontinent surgical repairs
  • Poor surgical candidate
  • History of rectal cancer or inflammatory bowel disease
  • Current rectovaginal
  • History of vaginal cancer
  • History of vaginal/pelvic radiation
  • Foreshortened vagina
  • Previous adverse reaction to Xenform matrix graft material
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00581594


Locations
United States, California
University of California, Irvine Medical Center
Orange, California, United States, 92868
Sponsors and Collaborators
University of California, Irvine
Investigators
Principal Investigator: Karen L Noblett, M.D. University of California, Irvine
  More Information

Responsible Party: Karen Noblett, Associate Professor, University of California, Irvine Medical Center
ClinicalTrials.gov Identifier: NCT00581594     History of Changes
Other Study ID Numbers: 2005-4574
First Submitted: December 20, 2007
First Posted: December 27, 2007
Last Update Posted: August 6, 2010
Last Verified: August 2010

Keywords provided by University of California, Irvine:
Pelvic organ prolapse
Posterior wall defects
Graft-augmented repair
Posterior colporrhaphy

Additional relevant MeSH terms:
Prolapse
Pelvic Organ Prolapse
Pathological Conditions, Anatomical