Effect of Vaginal Mesh Hysteropexy vs Vaginal Hysterectomy With Uterosacral Ligament Suspension on Treatment Failure in Women With Uterovaginal Prolapse: A Randomized Clinical Trial

摘要

Key PointsQuestionIs there a difference in treatment failure for vaginal mesh hysteropexy vs vaginal hysterectomy with uterosacral ligament suspension in women with uterovaginal prolapse? FindingsIn this randomized clinical trial that included 175 postmenopausal women with symptomatic uterovaginal prolapse undergoing surgical intervention, vaginal mesh hysteropexy compared with vaginal hysterectomy with uterosacral ligament suspension resulted in a hazard ratio for a composite measure of treatment failure of 0.62 after 3 years. This was not statistically significant, but the CI was wide and the P value was .06. MeaningAlthough vaginal mesh hysteropexy did not result in a statistically significantly better outcome compared with vaginal hysterectomy with uterosacral ligament suspension, the wide CI for the treatment effect precludes a definitive conclusion, and further research is needed to assess whether vaginal mesh hysteropexy is more effective than vaginal hysterectomy with uterosacral ligament suspension.