PROSPECT is a NIHR HTA funded trial of surgical options for the management of anterior and/or posterior vaginal wall prolapse (the PROSPECT trial). The aim is to evaluate new techniques which use mesh to reinforce the surgery because these have not yet been properly evaluated. As different surgical options are appropriate for women having a primary repair and those having a subsequent operation, this study will comprise two separate RCTs evaluating the two groups of women.
Women who are not eligible for randomisation will also be studied using the same study protocol and methods in a comprehensive cohort design.
PROSPECT recruited over 3000 women, half of whom were randomised, from 35 UK centres. In women who were having a primary repair, there was evidence of no benefit from the use of mesh inlay or biological graft compared with standard repair in terms of efficacy, QoL or adverse effects (other than mesh complications) in the first two years following prolapse surgery. The trials in women having a secondary repair was too small to be conclusive.
PROSPECT is led by Dr Fiona Reid based at Manchester University NHS Foundation Trust and Dr Suzanne Breeman based at the University of Aberdeen.
Follow-up to six years after surgery is ongoing.