Trial reportInternational urogynecology journal2021
Methods for the defining mechanisms of anterior vaginal wall descent (DEMAND) study.
Trial report in International urogynecology journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- MRI 2-D Parameters Associated with Native Tissue or Transvaginal Mesh Surgical Apical Prolapse Repair Failure.International urogynecology journal · 2026Article
- Urethral Morphology and Support Associated with Urinary Symptoms after Vaginal Surgery with and without Midurethral Sling.medRxiv : the preprint server for health sciences · 2026Article
- Sexual Function and Clitoral Anatomy after Vaginal Surgery with and without Midurethral Sling.medRxiv : the preprint server for health sciences · 2026Article
- Vaginal morphology and position associated with prolapse recurrence after vaginal surgery: A secondary analysis of the DEMAND study.BJOG : an international journal of obstetrics and gynaecology · 2024Article
- Variations in structural support site failure patterns by prolapse size on stress 3D MRI.International urogynecology journal · 2023Article
- Defining mechanisms of recurrence following apical prolapse repair based on imaging criteria.American journal of obstetrics and gynecology · 2021Article
- The establishment of a 3D anatomical coordinate system for defining vaginal axis and spatial position.Computer methods and programs in biomedicine · 2021Article
Corrections and comments
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Authors and funding
16 authors at 11 institutions in 1 country.
Funding
Abstract
introduction and hypothesisThe protocol and analysis methods for the Defining Mechanisms of Anterior Vaginal Wall Descent (DEMAND) study are presented. DEMAND was designed to identify mechanisms and contributors of prolapse recurrence after two transvaginal apical suspension procedures for uterovaginal prolapse.
methodsDEMAND is a supplementary cohort study of a clinical trial in which women with uterovaginal prolapse randomized to (1) vaginal hysterectomy with uterosacral ligament suspension or (2) vaginal mesh hysteropexy underwent pelvic magnetic resonance imaging (MRI) at 30-42 months post-surgery. Standardized protocols have been developed to systematize MRI examinations across multiple sites and to improve reliability of MRI measurements. Anatomical failure, based on MRI, is defined as prolapse beyond the hymen. Anatomic measures from co-registered rest, maximal strain, and post-strain rest (recovery) sequences are obtained from the "true mid-sagittal" plane defined by a 3D pelvic coordinate system. The primary outcome is the mechanism of failure (apical descent versus anterior vaginal wall elongation). Secondary outcomes include displacement of the vaginal apex and perineal body and elongation of the anterior wall, posterior wall, perimeter, and introitus of the vagina between (1) rest and strain and (2) rest and recovery.
resultsRecruitment and MRI trials of 94 participants were completed by May 2018.
conclusionsMethods papers which detail studies designed to evaluate anatomic outcomes of prolapse surgeries are few. We describe a systematic, standardized approach to define and quantitatively assess mechanisms of anatomic failure following prolapse repair. This study will provide a better understanding of how apical prolapse repairs fail anatomically.
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