{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T06:08:33Z","timestamp":1790489313630,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2011,8,22]],"date-time":"2011-08-22T00:00:00Z","timestamp":1313971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2011,11]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic> Vollebregt A, Fischer K, Gietelink D, van der Vaart C. Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar\u2010guided transobturator anterior mesh. BJOG 2011;118:1518\u20131527.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> To compare anterior colporrhaphy with a trocar\u2010guided transobturator mesh procedure (Avaulta<jats:sup>\u00ae<\/jats:sup> anterior).<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Randomised, controlled trial.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> Three teaching hospitals.<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> Women with a symptomatic cystocele at least stage II requiring primary surgical correction.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> A total of 125 women were assessed at baseline and 1\u2010year follow up. A sacrospinous hysteropexy or posterior colporrhaphy was performed when indicated.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> The primary outcome was the difference in anatomical cure (defined as Pelvic Organ Prolapse\u2010Quantification &lt;stage II cystocele). Secondary outcomes were complications, self\u2010reported urogenital symptom severity, and quality of life, as measured with validated questionnaires.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> In all, 64 women were allocated to the anterior colporrhaphy group and 61 to the mesh group; 58\/64 women versus 56\/61 completed 12\u2003months of follow\u2010up analysis. Compared with the anterior colporrhaphy group, the mesh reduced the risk of anatomical failure at 12\u2003months follow up from 59 to 9% (risk reduction 50.3%, 95% CI 35.5\u201365.1). Only three (5%) re\u2010operations for anatomical failure in the anterior colporrhaphy group were performed versus 0% in the mesh group. Functional outcome improved significantly at 12\u2003months on almost all domains, with similar results between groups. Mesh exposure occurred in two (4%) women. Baseline dyspareunia disappeared significantly more often after an anterior colporrhaphy (80%) than in the mesh group (20%). There was a trend towards more <jats:italic>de novo<\/jats:italic> dyspareunia in the mesh group (15% versus 9%).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Primary cystocele repair with trocar\u2010guided transobturator mesh resulted in a statistically significant better anatomical outcome compared with the anterior colporrhaphy. 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