Protocol for a Randomized Phase II Trial for Mesh Optimization by Autologous Plasma Coating in Prolapse Repair: IDEAL Stage 3

Holger Gerullis, Dimitri Barski, Evangelos Georgas, M. Borós, Albert Ramon, Thorsten H. Ecke, Silvia Selinski, Dörte Luedders, Mario W. Kramer, Alexander Winter, Friedhelm Wawroschek, Thomas Otto

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Mesh-related complications especially after vaginal implantation have raised awareness lately because of severe adverse reactions and legal aspects. About 20% of patients suffer from complications after mesh insertion in the anterior vaginal wall. Autologous plasma coating of meshes prior to implantation has shown potential to improve the biocompatibility of meshes in vivo and in vitro. This innovative approach has been developed according to the IDEAL recommendations for surgical innovations. The method has still to be assessed at stage 3 accordingly. Methods: A protocol is developed for a prospective single-blinded randomized controlled phase II trial for biocompatibility optimization of anterior vaginal meshes for prolapse repair by autologous plasma coating versus non-coated meshes. Results: The protocol aims at fulfilling the requirements for stage 3 (assessment) according to IDEAL. Eligible for inclusion are women with primary cystocele, requiring a surgical procedure, suitable for randomization, and willing to be randomized. Participants will be followed up by postal questionnaires (6 months post surgery and 12 months post randomization) and will also be reviewed in clinic 12 and 24 months post surgery. Primary endpoint is the assessment of mesh-related complications following the Clavien–Dindo classifications. QoL, sexual function assessment, efficacy, and validation of an already developed long-term register are considered secondary endpoints. To afford a calculated 10% reduction of postoperative complications through plasma-coated meshes vs. non-coated meshes at 1-year follow-up, a total 214 women in each arm will be necessary to achieve 80% power at a significance level of 5%. Conclusion: The protocol for this randomized clinical trial represents the conditions to assess the surgical innovation of plasma coating of meshes in order to improve the meshes’ biocompatibility at stage 3 according to the IDEAL recommendations.

Original languageEnglish
Pages (from-to)995-1006
Number of pages12
JournalAdvances in Therapy
Volume34
Issue number4
DOIs
Publication statusPublished - Apr 1 2017

Fingerprint

Prolapse
Random Allocation
Cystocele
Uterine Prolapse
Jurisprudence
Randomized Controlled Trials

Keywords

  • Clinical trial
  • IDEAL recommendations
  • Plasma coating
  • Prolapse repair
  • Quality of life
  • Surgical innovation
  • Surgical mesh
  • Vaginal prolapse

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

Cite this

Protocol for a Randomized Phase II Trial for Mesh Optimization by Autologous Plasma Coating in Prolapse Repair : IDEAL Stage 3. / Gerullis, Holger; Barski, Dimitri; Georgas, Evangelos; Borós, M.; Ramon, Albert; Ecke, Thorsten H.; Selinski, Silvia; Luedders, Dörte; Kramer, Mario W.; Winter, Alexander; Wawroschek, Friedhelm; Otto, Thomas.

In: Advances in Therapy, Vol. 34, No. 4, 01.04.2017, p. 995-1006.

Research output: Contribution to journalArticle

Gerullis, H, Barski, D, Georgas, E, Borós, M, Ramon, A, Ecke, TH, Selinski, S, Luedders, D, Kramer, MW, Winter, A, Wawroschek, F & Otto, T 2017, 'Protocol for a Randomized Phase II Trial for Mesh Optimization by Autologous Plasma Coating in Prolapse Repair: IDEAL Stage 3', Advances in Therapy, vol. 34, no. 4, pp. 995-1006. https://doi.org/10.1007/s12325-017-0493-z
Gerullis, Holger ; Barski, Dimitri ; Georgas, Evangelos ; Borós, M. ; Ramon, Albert ; Ecke, Thorsten H. ; Selinski, Silvia ; Luedders, Dörte ; Kramer, Mario W. ; Winter, Alexander ; Wawroschek, Friedhelm ; Otto, Thomas. / Protocol for a Randomized Phase II Trial for Mesh Optimization by Autologous Plasma Coating in Prolapse Repair : IDEAL Stage 3. In: Advances in Therapy. 2017 ; Vol. 34, No. 4. pp. 995-1006.
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abstract = "Introduction: Mesh-related complications especially after vaginal implantation have raised awareness lately because of severe adverse reactions and legal aspects. About 20{\%} of patients suffer from complications after mesh insertion in the anterior vaginal wall. Autologous plasma coating of meshes prior to implantation has shown potential to improve the biocompatibility of meshes in vivo and in vitro. This innovative approach has been developed according to the IDEAL recommendations for surgical innovations. The method has still to be assessed at stage 3 accordingly. Methods: A protocol is developed for a prospective single-blinded randomized controlled phase II trial for biocompatibility optimization of anterior vaginal meshes for prolapse repair by autologous plasma coating versus non-coated meshes. Results: The protocol aims at fulfilling the requirements for stage 3 (assessment) according to IDEAL. Eligible for inclusion are women with primary cystocele, requiring a surgical procedure, suitable for randomization, and willing to be randomized. Participants will be followed up by postal questionnaires (6 months post surgery and 12 months post randomization) and will also be reviewed in clinic 12 and 24 months post surgery. Primary endpoint is the assessment of mesh-related complications following the Clavien–Dindo classifications. QoL, sexual function assessment, efficacy, and validation of an already developed long-term register are considered secondary endpoints. To afford a calculated 10{\%} reduction of postoperative complications through plasma-coated meshes vs. non-coated meshes at 1-year follow-up, a total 214 women in each arm will be necessary to achieve 80{\%} power at a significance level of 5{\%}. Conclusion: The protocol for this randomized clinical trial represents the conditions to assess the surgical innovation of plasma coating of meshes in order to improve the meshes’ biocompatibility at stage 3 according to the IDEAL recommendations.",
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AU - Borós, M.

AU - Ramon, Albert

AU - Ecke, Thorsten H.

AU - Selinski, Silvia

AU - Luedders, Dörte

AU - Kramer, Mario W.

AU - Winter, Alexander

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