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Serious complications and recurrences after pelvic organ prolapse surgery for 2309 women in the VIGI-MESH registry
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  • Xavier Fritel,
  • Renaud de Tayrac,
  • Joe de Keizer,
  • Sandrine Campagne-Loiseau,
  • Michel Cosson,
  • Philippe Ferry,
  • Xavier Deffieux,
  • Jean-Philippe Lucot,
  • Laurent Wagner,
  • Philippe Debodinance,
  • Christian Saussine,
  • Anne-Cécile Pizzoferrato,
  • Caroline Carlier-Guérin,
  • Thibault Thubert,
  • Laure Panel,
  • Pierre-Olivier Bosset,
  • Elvis Nkounkou,
  • Rajeev Ramanah,
  • Thomas Boisramé,
  • Thomas Charles,
  • Cyril Raiffort,
  • Amélie Charvériat,
  • Stéphanie Ragot,
  • Arnaud Fauconnier
Xavier Fritel
CHU de Poitiers
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Renaud de Tayrac
CHU Carémeau
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Joe de Keizer
Université de Poitiers UFR Médecine et Pharmacie
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Sandrine Campagne-Loiseau
CHU Estaing
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Michel Cosson
Hopital Jeanne de Flandre, Centre Hospitalier Regional Universitaire de Lille
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Philippe Ferry
CH La Rochelle
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Xavier Deffieux
CHU Antoine Beclere
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Jean-Philippe Lucot
Hôpital Saint-Vincent de Paul
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Laurent Wagner
Medical University Nimes
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Philippe Debodinance
CH Dunkerque
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Christian Saussine
CHU Strasbourg
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Anne-Cécile Pizzoferrato
CHU Caen
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Caroline Carlier-Guérin
CH de Châtellerault
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Thibault Thubert
Centre Hospitalier Universitaire de Nantes
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Laure Panel
Clinique Beau Soleil
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Pierre-Olivier Bosset
Hôpital Foch
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Elvis Nkounkou
CH de Béthune
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Rajeev Ramanah
CHU Besancon
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Thomas Boisramé
CHU Strasbourg
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Thomas Charles
CHU Poitiers
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Cyril Raiffort
Groupe Hospitalier Diaconesses Croix Saint-Simon Site Avron
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Amélie Charvériat
CHU de Poitiers
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Stéphanie Ragot
Université de Poitiers UFR Médecine et Pharmacie
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Arnaud Fauconnier
CHI Poissy-Saint-Germain-en-Laye Pôle femme-mère-enfant
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Abstract

Objective: To assess the incidence of serious complications and reoperations for recurrence after pelvic organ prolapse (POP) surgery and compare the three most common types of repair. Design: Prospective cohort study using a registry. Setting: 19 surgical centres in France. Population: 2309 women participated between 2017 and 2019. Methods: a multivariate analysis including an inverse probability of treatment weighting approach was used to obtain three comparable groups. Main outcome measures: Serious complications and subsequent reoperations for POP recurrence Results: Mean follow-up was 16.6 months. Surgeries included in the analysis were native tissue vaginal repair (N=504), transvaginal mesh placement (692), and laparoscopic sacropexy with mesh (1113). Serious complications occurred among 52 women (2.3%), and reoperation for recurrence was required for 32 (1.4%). At one year, the cumulative weighted incidence of serious complications was 1.8% for native tissue vaginal repair (95% confidence interval 0-3.9), 3.9% for transvaginal mesh (2.0-5.9), and 2.2% for sacropexy (1.1-2.6). Compared with the native tissue vaginal repair group, the risk of serious complications was higher in the transvaginal mesh group (weighted-HR 3.84, 2.43-6.08), and the sacropexy group (2.48, 1.45-4.23), while the risk of reoperation for prolapse recurrence was reduced in both groups (transvaginal mesh [0.22, 0.13-0.39] and sacropexy [0.29, 0.18-0.47]). Conclusions: Laparoscopic sacropexy with mesh appears to have a better risk profile (few serious complications and few reoperations for recurrence) than transvaginal mesh placement (more serious complications) and native tissue vaginal repair (more reoperations for recurrence). These results are useful for informing women and for shared decision making.

Peer review status:IN REVISION

29 Mar 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
31 Mar 2021Assigned to Editor
31 Mar 2021Submission Checks Completed
02 Apr 2021Reviewer(s) Assigned
22 Apr 2021Review(s) Completed, Editorial Evaluation Pending
28 May 2021Editorial Decision: Revise Major