The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial

The aim of the study was to compare the efficacy and safety of transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy for treatment of anterior vaginal wall prolapse.This is a randomized controlled trial in which women with advanced anterior vaginal wall prolapse, at least stage II with Ba a parts per thousand yenaEuro parts per thousand+1 cm according to the Pelvic Organ Prolapse Quantification (POP-Q) classification, were randomly assigned to have either anterior colporrhaphy (n = 39) or repair using trocar-guided transvaginal mesh (n = 40). the primary outcome was objective cure rate of the anterior compartment (point Ba) assessed at the 12-month follow-up visit, with stages 0 and I defined as anatomical success. Secondary outcomes included quantification of other vaginal compartments (POP-Q points), comparison of quality of life by the prolapse quality of life (P-QOL) questionnaire, and complication rate between the groups after 1 year. Study power was fixed as 80 % with 5 % cutoff point (p < 0.05) for statistical significance.The groups were similar regarding demographic and clinical preoperative parameters. Anatomical success rates for colporrhaphy and repair with mesh placement groups were 56.4 vs 82.5 % (95 % confidence interval 0.068-0.54), respectively, and the difference between the groups was statistically significant (p = 0.018). Similar total complication rates were observed in both groups, with tape exposure observed in 5 % of the patients. There was a significant improvement in all P-QOL domains as a result of both procedures (p < 0.001), but they were not distinct between groups (p > 0.05).Trocar-guided transvaginal synthetic mesh for advanced anterior POP repair is associated with a higher anatomical success rate for the anterior compartment compared with traditional colporrhaphy. Quality of life equally improved after both techniques. However, the trial failed to detect differences in P-QOL scores and complication rates between the groups.

Anthropometry of the Breast Region: How to Measure?

Breast region measurements are important for research, but they may also become significant in the legal field as a quantitative tool for preoperative and postoperative evaluation. Direct anthropometric measurements can be taken in clinical practice. the aim of this study was to compare direct breast anthropometric measurements taken with a tape measure and a compass.Forty women, aged 18-60 years, were evaluated. They had 14 anatomical landmarks marked on the breast region and arms. the union of these points formed eight linear segments and one angle for each side of the body. the volunteers were evaluated by direct anthropometry in a standardized way, using a tape measure and a compass.Differences were found between the tape measure and the compass measurements for all segments analyzed (p > 0.05).Measurements obtained by tape measure and compass are not identical. Therefore, once the measurement tool is chosen, it should be used for the pre- and postoperative measurements in a standardized way.This journal requires that authors assign a level of evidence to each article. for a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.