Prophylactic Uterosacral Ligament Suspension at the Time of Hysterectomy for Prevention of Vaginal Vault Prolapse
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Purpose
Is routine uterosacral ligament suspension an appropriate clinical adjunct at the time of hysterectomy?
The answers to these questions will facilitate the treatment of many American women. With the results of this study, the investigators would anticipate a reduction in the number of surgeries for pelvic organ prolapse. In addition, if uterosacral ligament suspension was shown to be ineffective, it would not be used routinely in the setting of hysterectomy and women will be spared the additional procedure and possibility of side effects or complications.
The relative risks and benefits of adding a prophylactic uterosacral ligament suspension at the time of hysterectomy in women without symptomatic prolapse symptoms have never been studied prospectively.
| Condition | Intervention |
|---|---|
|
Prolapse of Vaginal Vault After Hysterectomy |
Procedure: uterosacral ligament suspension colpopexy bilateral |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Prophylactic Uterosacral Ligament Suspension at the Time of Hysterectomy for Prevention of Vaginal Vault Prolapse (PULS) |
- To compare the occurrence of objective findings of pelvic organ prolapse beyond hymen after uterosacral ligament suspension of the vaginal apex at the time of hysterectomy vs. hysterectomy alone using Pelvic Floor Quantitative Examination [ Time Frame: one year and annual thereafter for 5 years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 168 |
| Study Start Date: | August 2011 |
| Estimated Study Completion Date: | April 2019 |
| Estimated Primary Completion Date: | April 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: uterosacral ligament suspension
uterosacral ligament suspension colpopexy sutures will be placed bilaterally at the time of hysterectomy
|
Procedure: uterosacral ligament suspension colpopexy bilateral
Uterosacral ligament suspension colpopexy bilateral
Other Name: uterosacral ligament suspension at the time of hysterectomy
|
| No Intervention: hysterectomy alone |
Eligibility| Ages Eligible for Study: | 21 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Eligibility for primary procedure (hysterectomy either total or supracervical, performed either vaginally or abdominally, via laparoscopic or open approach)
- Eligibility for secondary procedure (uterosacral ligament suspension colpopexy)
- Prolapse in any compartment not extending beyond the hymen as measured by Pelvic Organ Prolapse Quantitative system
- No subjective complaints of Pelvic Organ Prolapse as determined by answer "no" to questions #3 of the short form of Pelvic Floor Distress Inventory: #3. Do you usually have a bulge or something falling out that you can see or feel in the vaginal area?
Exclusion Criteria:
- Contraindication for uterosacral ligament suspension colpopexy. (Surgeon's judgment that a contraindication to uterosacral ligament suspension colpopexy exists).
- Anticipated geographic relocation within the 12 months after surgery
- Inability to provide informed consent or to complete testing or data collection.
Contacts and Locations| Contact: Marianna Alperin, MD, MS | 617-970-3164 | malperin@ucsd.edu |
| United States, California | |
| Kaiser Permanente West Los Angeles | Recruiting |
| Los Angeles, California, United States, 90034 | |
| Contact: Marianna Alperin, MD, MS 323-857-2238 Mariann.X.Alperin@kp.org | |
| Principal Investigator: Marianna Alperin, MD, MS | |
More Information
No publications provided
| Responsible Party: | Marianna Alperin, M.D. M.S., Principal Investigator, Kaiser Permanente |
| ClinicalTrials.gov Identifier: | NCT01364025 History of Changes |
| Other Study ID Numbers: | PULS |
| Study First Received: | May 31, 2011 |
| Last Updated: | January 25, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Prolapse Pelvic Organ Prolapse Pathological Conditions, Anatomical |
ClinicalTrials.gov processed this record on May 19, 2013