Status:

COMPLETED

Study of Uterine Prolapse Procedures - Randomized Trial

Lead Sponsor:

NICHD Pelvic Floor Disorders Network

Collaborating Sponsors:

Boston Scientific Corporation

Conditions:

Uterovaginal Prolapse

Eligibility:

FEMALE

21+ years

Phase:

NA

Brief Summary

The primary purpose of this randomized clinical trial is to compare the effectiveness and safety of two transvaginal apical suspension strategies for uterovaginal prolapse: a mesh augmented hysteropex...

Detailed Description

The study population will be adult women (\>21 years of age) with symptomatic uterovaginal prolapse at or beyond the hymen who desire vaginal surgical management. This study is intended to be done onl...

Eligibility Criteria

Inclusion

  • Women aged 21 or older who have completed child -bearing
  • Prolapse beyond the hymen (defined as Ba, Bp, or C \> 0 cm)
  • Uterine descent into at least the lower half of the vagina (defined as point C\> -TVL/2) )
  • Bothersome bulge symptoms as indicated on question 3 of the PFDI-20 form relating to 'sensation of bulging' or 'something falling out'
  • Desires vaginal surgical treatment for uterovaginal prolapse
  • Available for up to 60 month follow-up
  • Amenorrhea for the past 12 months from either menopause or endometrial ablation
  • Not pregnant, not at risk for pregnancy or agree to contraception if at risk for pregnancy (only applicable to the rare endometrial ablation patient)
  • Eligible for no cervical cancer screening for at least 3 years

Exclusion

  • Previous synthetic material (placed vaginally or abdominally) to augment POP repair
  • Known previous uterosacral or sacrospinous uterine suspension
  • Known adverse reaction to synthetic mesh or biological grafts; these complications include but are not limited to erosion, fistula, or abscess
  • Chronic pelvic pain
  • Pelvic radiation
  • Cervical elongation- defined as an expectation that the C point would be Stage 2 or greater postoperatively if a hysteropexy was performed. (Note: cervical shortening or trachelectomy is not an allowed intraoperative procedure within the hysteropexy treatment group).
  • Women at increased risk of cervical dysplasia requiring cervical cancer screening more often than every 3 years (e.g. HIV+ status, immunosuppression because of transplant related medications, Diethylstilbestrol (DES) exposure in utero, or previous treatment for cervical intraepithelial neoplasia (CIN)2, CIN3, or cancer)
  • Uterine abnormalities (symptomatic uterine fibroids, polyps, endometrial hyperplasia, endometrial cancer, or any uterine disease that precluded prolapse repair with uterine preservation in the opinion of the surgeon
  • Indication for ovarian removal (adnexal mass, BRCA 1/2 positivity, family history of ovarian cancer)
  • Current condition of amenorrhea caused by exogenous sex steroids or hypothalamic conditions.

Key Trial Info

Start Date :

April 1 2013

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

March 7 2025

Estimated Enrollment :

183 Patients enrolled

Trial Details

Trial ID

NCT01802281

Start Date

April 1 2013

End Date

March 7 2025

Last Update

August 26 2025

Active Locations (8)

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Page 1 of 2 (8 locations)

1

University of Alabama at Birmingham, Department of Obstetrics and Gynecology

Birmingham, Alabama, United States, 35249

2

University of California at San Diego, UCSD Women's Pelvic Medicine Center

La Jolla, California, United States, 92037-0974

3

University of New Mexico Health Sciences Center, Department of Obstetrics and Gynecology

Albuquerque, New Mexico, United States, 87131

4

Duke University, Duke Division of Urogynecology and Reconstructive Pelvic Surgery

Durham, North Carolina, United States, 27707