The outcome of transobturator anterior vaginal wall prolapse repair using porcine dermis graft: intermediate term follow-up

被引:7
作者
Mahdy, Ayman [1 ]
Karp, Deborah [2 ]
Davila, G. Willy [3 ]
Ghoniem, Gamal M. [4 ]
机构
[1] Univ Cincinnati, Dept Surg, Div Urol, Sect Female Urol, Cincinnati, OH 45267 USA
[2] Emory Univ, Sch Med, Dept Gynecol & Obstet, Atlanta, GA USA
[3] Cleveland Clin, Sect Urogynecol & Pelv Reconstruct Surg, Dept Gynecol, Weston, FL USA
[4] Univ Calif Irvine, Div Female Urol, Pelv Reconstruct Surg & Voiding Dysfunct, Dept Urol, Orange, CA 92668 USA
来源
INTERNATIONAL BRAZ J UROL | 2013年 / 39卷 / 04期
关键词
Prolapse; Transplants; Cystocele; Vagina; PELVIC ORGAN PROLAPSE; POLYPROPYLENE MESH; CYSTOCELE REPAIR; TRIAL; COLPORRHAPHY; COMPARTMENT; DEFECTS;
D O I
10.1590/S1677-5538.IBJU.2013.04.08
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction and Hypothesis: We evaluated the anatomical success and complications of Perigee (R) with porcine dermis Graft in the repair of anterior vaginal wall prolapse (AVWP) Materials and Methods: After Institutional Review Board (IRB) approval, the charts of all patients who underwent AVWP repair using the Perigee/InteXen (R) kit from July 2005 to July 2009 were reviewed. Patients who had less than 6-month follow-up were excluded. Preoperative data including patient age, previous AVWP repairs, hysterectomy status, preoperative dyspareunia and pertinent physical findings were collected and recorded. Postoperative success was defined as anatomical stage 0 or I using the Pelvic Organ Prolapse Quantification (POP-Q) scoring system. Graft related complications were also recorded. Results: Out of 89 patients, 69 completed at least 6-month follow-up. Median follow-up was 13 (6-48) months. Seventeen patients (25%) had previous AVWP repair and 32 (46%) had previous hysterectomy. Preoperatively, AVWP stage II was found in 9 (13%), stage III in 27 (39%) and stage IV in 33 (48%) patients. Anatomic success was found in 48 (69%) patients, with 23 (33%) having stage 0 and 25 (36%) stage I AVWP. Intraoperative complications included incidental cystotomy in one patient and bladder perforation in one. Postoperative complications included vaginal exposure and dyspareunia in one case, wound dehiscence in one and tenderness over the graft arm with dyspareunia in one. Conclusions: The use of porcine dermis in AVWP repair is safe with minimal graft related complications; however, anatomical success is lower than that reported with the use of synthetic grafts.
引用
收藏
页码:506 / 512
页数:7
相关论文
共 25 条
[1]   Transvaginal cystocele correction: Midterm results with a transobturator tension-free technique using a combined bovine pericardium/polypropylene mesh [J].
Araco, Francesco ;
Gravante, Gianpiero ;
Overton, John ;
Araco, Placido ;
Dati, Stefano .
JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, 2009, 35 (05) :953-960
[2]   Surgical techniques for vault prolapse: a review of the literature [J].
Beer, M ;
Kuhn, A .
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2005, 119 (02) :144-155
[3]   A prospective, randomized controlled trial of the use of an anal purse-string suture to decrease contamination during pelvic reconstructive surgery [J].
Biller, Daniel H. ;
Guerette, Nathan L. ;
Bena, James F. ;
Davila, G. Willy .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2008, 19 (01) :59-63
[4]   Mechanical properties of synthetic implants used in the repair of prolapse and urinary incontinence in women:: which is the ideal material? [J].
Cosson, M ;
Debodinance, P ;
Boukerrou, M ;
Chauvet, MP ;
Lobry, P ;
Crépin, G ;
Ego, A .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2003, 14 (03) :169-178
[5]  
Cosson M, 2003, INT UROGYNECOL J PEL, V14, P178
[6]  
Debodinance P, 2006, J Gynecol Obstet Biol Reprod (Paris), V35, P429
[7]   Management of the complications of the synthetic slings [J].
Deval, Bruno ;
Haab, Francois .
CURRENT OPINION IN UROLOGY, 2006, 16 (04) :240-243
[8]   Cystocele repair by transobturator four arms mesh: monocentric experience of first 123 patients [J].
Eboue, Cyril ;
Marcus-Braun, Naama ;
von Theobald, Peter .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2010, 21 (01) :85-93
[9]  
Eglin G, 2003, Gynecol Obstet Fertil, V31, P14, DOI 10.1016/S1297-9589(02)00011-5
[10]   Porcine dermis interposition graft for repair of high grade anterior compartment defects with or without concomitant pelvic organ prolapse procedures [J].
Gomelsky, A ;
Rudy, DC ;
Dmochowski, RR .
JOURNAL OF UROLOGY, 2004, 171 (04) :1581-1584