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Trial registered on ANZCTR
Registration number
ACTRN12615000427572
Ethics application status
Approved
Date submitted
30/09/2014
Date registered
5/05/2015
Date last updated
5/05/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
Comparative study of laparoscopic versus abdominal sacral colpopexy in women with Grade III or IV uterovaginal prolapse
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Scientific title
Comparative study of laparoscopic versus abdominal sacral colpopexy in women with Grade III or IV uterovaginal prolapse evaluating operating room time, estimated blood loss , inpatient days, and recurrence
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Secondary ID [1]
285418
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nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Uterovaginal prolapse
293164
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Condition category
Condition code
Reproductive Health and Childbirth
293443
293443
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0
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Other reproductive health and childbirth disorders
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Surgery
293645
293645
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0
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Surgical techniques
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Renal and Urogenital
293646
293646
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Physical Examination: preoperative physical examination will be performed in the supine position with the Valsalva maneuver. Genital prolapse will be staged according to the pelvic organ prolapse quantification (POP-Q) as described by the International Continence Society by a gynaecologist with consistent experience.
Pre-operative Pap smear.
Preoperative urodynamic study (cystometry) .
All operations will take place under general anaesthesia in a lithotomy position with legs laid flat, with a Foley catheter in the bladder.
A retroperitoneal approach will be used in all cases. The posterior parietal peritoneum is incised vertically from the promontory to the vaginal apex, between the midline and the right ureter.
Dissection of the peritoneal covering of the back of the cervix or the vagina.
The presacral ligament is exposed in the midline over S1 by careful dissection avoiding injury to the median sacral vessels.
Monofilament polypropylene mesh (Prolene) mesh will be sutured to the ligament and the vagina.
Group A: (15 patient)
Where laparoscopic sacrocolpopexy will be done through 4 trocar ports with average duration of 100-200 min.
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Intervention code [1]
290335
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Treatment: Surgery
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Comparator / control treatment
Group B:(15 patient)
Where abdominal sacrocolpopexy will be done through laparotomy with duration of 60-90 min.
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Control group
Active
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Outcomes
Primary outcome [1]
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duration of hospital stay
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Assessment method [1]
293263
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Timepoint [1]
293263
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At hospital discharge
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Primary outcome [2]
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recurrence of Uterovaginal prolapse
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Assessment method [2]
293460
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Timepoint [2]
293460
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followup by POP-Q at 1, 3, 6, and 12 months post surgery.
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Secondary outcome [1]
310692
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Intra- and postoperative complications such as bladder , rectal injuries.
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Assessment method [1]
310692
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Timepoint [1]
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Intra-operatively and up to 24 hours post-operative.
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Secondary outcome [2]
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quality of life by using SF-36 Quality of Life Questionnaire
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Assessment method [2]
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Timepoint [2]
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quality of life will be assessed at 1,6,12 months postoperative
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Secondary outcome [3]
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satisfaction by SF-36 Quality of Life Questionnaire and visual analogue bother score .
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Assessment method [3]
311100
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Timepoint [3]
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visual analogue score (VAS) score and questionnaire will be assessed at 1,6,12 months postoperative
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Eligibility
Key inclusion criteria
1. Grade III or IV uterovaginal prolapse according to the pelvic organ prolapse quantification (POP-Q).
2. Uterine or vault prolapse .
3. Normal uterus and ovaries on ultrasound examination.
4. Normal menstrual bleeding pattern (if premenopausal).
5. Normal Pap smear.
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Minimum age
30
Years
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Maximum age
80
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Inability to give informed consent or to return for follows up.
2. Unable to undergo general anaesthesia.
3. Prior sacral colpopexy.
4. Patients presenting with lower grade prolapse.
5. Genuine stress incontinence.
6. Indication for hysterectomy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2012
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Actual
1/07/2012
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Date of last participant enrolment
Anticipated
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Actual
1/01/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
6382
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Egypt
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State/province [1]
6382
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Funding & Sponsors
Funding source category [1]
290023
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Hospital
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Name [1]
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el-shatby maternity university hospital
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Address [1]
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15 port saeed street, alexandria , 22022
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Country [1]
290023
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Egypt
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Primary sponsor type
University
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Name
alexandria university, faculty of medicne
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Address
15 port saeed street, alexandria ,22022
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Country
Egypt
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Secondary sponsor category [1]
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Individual
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Name [1]
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ahmed samy el-agwany
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Address [1]
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el-shatby maternity hospital,
15 port saeed street, alexandria ,22022
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Country [1]
288711
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Egypt
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
This study was undertaken to compare laparoscopic and open sacral colpopexies for efficacy and safety. This prospective randomized controlled study was conducted in the Gynecologic Department of El-Shatby Maternity Hospital , University of Alexandria in Egypt. It involved 30 women selected after fulfilling the criteria of inclusion into the study with informed consent to participate in the study. All patients in this study were randomly allocated into one of the two following groups: Group A: (15 patient) Where laparoscopic sacrocolpopexy was done. Group B :( 15 patient) Where abdominal (open) sacrocolpopexy was done. Demographic and hospital data, complications, and follow-up visits were reviewed. Median follow-up was 12 months in the laparoscopic and open groups. Mean operating time was significantly greater in the laparoscopic versus open cohort, 70 minutes and 90 minutes, respectively . Estimated blood loss (84 mL vs 156 ml) and hospital stay (2 vs 1 day ) were significantly less in the laparoscopic group than the open group. Hospital stay was was significant less in laparoscopy versus open groeup (2 versus 4 days ). Demographic data , other perioperative data, quality of life assessment , subjective , objective cure rates , complications and reoperation rates were non-significant. As a conclusion, Laparoscopic and open sacral colpopexies have comparable clinical outcomes. Although laparoscopic sacral colpopexy requires longer operating time, hospital stay and blood loss are significantly decreased. Postoperatively overall quality of life and sexual quality showed significant improvement .The subjective cure rate was 90% , the objective cure rate (no prolapse in any compartment) was 100%.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr ahmed samy el-agwany
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Address
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Department of Obstetrics and Gynecology,
El-shatby maternity university hospital,
Faculty of Medicine, Alexandria University, Alexandria, Egypt
15 portsaeed street, alexandria ,22022
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Country
51774
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Egypt
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Phone
51774
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+201228254247
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Fax
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Email
51774
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[email protected]
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Contact person for public queries
Name
51775
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ahmed samy el-agwany
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Address
51775
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Department of Obstetrics and Gynecology,
El-shatby maternity university hospital,
Faculty of Medicine, Alexandria University, Alexandria, Egypt
15 portsaeed street, alexandria ,22022
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Country
51775
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Egypt
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Phone
51775
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+201228254247
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Fax
51775
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Email
51775
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[email protected]
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Contact person for scientific queries
Name
51776
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ahmed samy el-agwany
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Address
51776
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Department of Obstetrics and Gynecology,
El-shatby maternity university hospital,
Faculty of Medicine, Alexandria University, Alexandria, Egypt
15 port saeed street, alexandria ,22022
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Country
51776
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Egypt
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Phone
51776
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+201228254247
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Fax
51776
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Email
51776
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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