VUE

VUE:  Vault or Uterine prolapse surgery Evaluation: two parallel randomised controlled trials of surgical options for upper compartment (uterine or vault) pelvic organ prolapsed

Gynaecologists have recognised for some time that both anatomical failure and recurrence of prolapse symptoms after surgery are common: one in three women who have a prolapse operation will go on to have another, though not necessarily in the same compartment. More recently, it has also been recognised that surgery can be followed by a greater impairment of quality of life than from the original prolapse itself (for example the development of new-onset urinary incontinence after surgery, or prolapse at a different site). Whilst anterior and posterior prolapse surgery is most common (90% of operations), around 43% of women also have a uterine (34%) or vault (9%) procedure at the same time. Indeed, this demonstrates that women who have a hysterectomy have around a 27% chance of needing a subsequent vault prolapse repair. These data are derived from the first 700 women recruited in PROSPECT, a large HTA-funded UK RCT of anterior or posterior prolapse surgery with or without the use of mesh (HTA No. 07/60/18). In VUE, the opportunity has arose to then switch from randomising between lower compartment surgery to trials involving different surgical options for upper compartment prolapse (uterine and vault).

HERU researchers involved in this research project: Mary Kilonzo

External collaborators: C Glazener, S Breeman, G McPherson, A McDonald, J Norrie, A Elders (HSRU, University of Aberdeen); I.B.G. Montgomery, (University of Aberdeen); S Hagen (Glasgow Caledonian University); A.R.B. Smith (St. Mary’s Hospital Manchester); R.M Freeman (Plymouth Hospital NHS Trust); C Bain and K Cooper (NHS Grampian)

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Publications

Glazener, C., Constable, L., Hemming, C., Breeman, S., Elders, A., Cooper, K., Freeman, R., Smith, A. R., Hagen, S., McDonald, A., McPherson, G., Montgomery, I., Kilonzo, M., Boyers, D., Goulao, B. and Norrie, J. (2016) 'Two parallel, pragmatic, UK multicentre, randomised controlled trials comparing surgical options for upper compartment (vault or uterine) pelvic organ prolapse (the VUE Study): study protocol for a randomised controlled trial' [Protocol], Trials, 17(1), 441.

Hemming, C., Constable, L., Goulao, B., Kilonzo, M., Boyers, D., Elders, A., Cooper, K., Smith, A., Freeman, R., Breeman, S., McDonald, A., Hagen, S., Montgomery, I., Norrie, J. and Glazener, C. (2018) Vault or Uterine prolapse surgery Evaluation: two parallel randomised controlled trials of surgical options for apical compartment pelvic organ prolapse (VUE). Final report submitted to the National Institute for Health Research (NIHR) Health Technology Assessment Programme.

Hemming, C., Constable, L., Goulao, B., Kilonzo, M., Boyers, D., Elders, A., Cooper, K., Smith, A., Freeman, R., Breeman, S., McDonald, A., Hagen, S., Montgomery, I., Norrie, J. and Glazener, C. (2020) 'Surgical interventions for uterine prolapse and for vault prolapse: the two VUE RCTs', Health Technology Assessment, 24(13).

Presentations

Hemming, C., Constable, L., Boyers, D., Breeman, S., Goulao, B., Cooper, K., Freeman, R., Smith, A., Elders, A., Hagen, S. and Glazener, C. (2018) 'VUE: two UK based multicentre parallel randomised controlled surgical trials for uterine and vault prolapse' [poster], International Continence Society (ICS), Philadelphia, USA, August 2018.