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Erschienen in: International Urogynecology Journal 8/2011

01.08.2011 | Original Article

Biologic grafts for cystocele repair: does concomitant midline fascial plication improve surgical outcomes?

verfasst von: Deborah R. Karp, Thais V. Peterson, Ayman Mahdy, Gamal Ghoniem, Vivian C. Aguilar, G. Willy Davila

Erschienen in: International Urogynecology Journal | Ausgabe 8/2011

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Abstract

Introduction and hypothesis

This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication.

Methods

Women with symptomatic anterior prolapse who underwent transvaginal repair, using biologic graft via transobturator approach, were retrospectively studied. An initial cohort had the graft placed without fascial plication. A second cohort had graft placement as an overlay to fascial plication.

Results

Between March 2005 and September 2008, 65 subjects underwent anterior repair with biologic graft; 35 without fascial plication and 30 as an overlay to plication. At 6 months follow-up, anatomic recurrence (Ba>/= −1) was significantly higher in the non-plicated group (18/35, 51%) compared with the plicated group (2/30, 7%) p < 0.01. Five (5/35, 14%) in the non-plicated group compared with none (0/30) in the plicated group underwent further treatment (p = 0.06).

Conclusions

When using a non-crosslinked biologic graft for repair of anterior vaginal prolapse, we recommend the addition of concomitant midline fascial plication to enhance anatomic outcome.
Literatur
1.
Zurück zum Zitat Maher CF, Baessler K, Glazener CMA, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18: CD004014 Maher CF, Baessler K, Glazener CMA, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18: CD004014
2.
Zurück zum Zitat Feiner B, Maher CF (2010) Vaginal mesh contraction: definition, clinical presentation, and management. Obstet Gynecol 115:325–330PubMedCrossRef Feiner B, Maher CF (2010) Vaginal mesh contraction: definition, clinical presentation, and management. Obstet Gynecol 115:325–330PubMedCrossRef
3.
Zurück zum Zitat Natale F, Penna CL, Padoa A, Agostini M, DeSimone E, Cervigni M (2009) A prospective, randomized, controlled study comparing Gynemesh, a synthetic mesh, and Pelvicol, a biologic graft, in the surgical treatment of recurrent cystocele. Int Urogynecol 20:75–81CrossRef Natale F, Penna CL, Padoa A, Agostini M, DeSimone E, Cervigni M (2009) A prospective, randomized, controlled study comparing Gynemesh, a synthetic mesh, and Pelvicol, a biologic graft, in the surgical treatment of recurrent cystocele. Int Urogynecol 20:75–81CrossRef
4.
Zurück zum Zitat Mouritsen L, Kronschnabl M, Lose G (2010) Long-term results of vaginal repairs with and without xenograft reinforcement. Int Urogynecol J 21:467–473PubMedCrossRef Mouritsen L, Kronschnabl M, Lose G (2010) Long-term results of vaginal repairs with and without xenograft reinforcement. Int Urogynecol J 21:467–473PubMedCrossRef
5.
Zurück zum Zitat Mahdy A, Elmissiry M, Ghoniem G (2008) The outcome of transobturator cystocele repair using biocompatible porcine dermis graft: our experience with 32 cases. Int Urogynecol J 19:1647–1652CrossRef Mahdy A, Elmissiry M, Ghoniem G (2008) The outcome of transobturator cystocele repair using biocompatible porcine dermis graft: our experience with 32 cases. Int Urogynecol J 19:1647–1652CrossRef
6.
Zurück zum Zitat Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef
7.
Zurück zum Zitat Guerette NL, Peterson TV, Aguirre OA, VanDrie DM, Biller DH, Davila GW (2009) Anterior repair with or without collagen matrix reinforcement: a randomized controlled trial. Obstet Gynecol 114:59–65PubMed Guerette NL, Peterson TV, Aguirre OA, VanDrie DM, Biller DH, Davila GW (2009) Anterior repair with or without collagen matrix reinforcement: a randomized controlled trial. Obstet Gynecol 114:59–65PubMed
8.
Zurück zum Zitat Shippey S, Gutman RE, Quiroz LH, Handa VL (2008) Contemporary approaches to cystocele repair: a survey of AUGS members. J Reprod Med 53:832–836PubMed Shippey S, Gutman RE, Quiroz LH, Handa VL (2008) Contemporary approaches to cystocele repair: a survey of AUGS members. J Reprod Med 53:832–836PubMed
9.
Zurück zum Zitat Gandhi S, Goldberg RP, Kwon C, Koduri S, Beaumont JL, Abramov Y et al (2005) A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse. Am J Obstet Gynecol 192:1649–1654PubMedCrossRef Gandhi S, Goldberg RP, Kwon C, Koduri S, Beaumont JL, Abramov Y et al (2005) A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse. Am J Obstet Gynecol 192:1649–1654PubMedCrossRef
10.
Zurück zum Zitat Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kocjancic E (2007) Porcine skin collagen implants to prevent anterior vaginal wall prolapse: a multicenter, randomized study. J Urol 177:192–195PubMedCrossRef Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kocjancic E (2007) Porcine skin collagen implants to prevent anterior vaginal wall prolapse: a multicenter, randomized study. J Urol 177:192–195PubMedCrossRef
11.
Zurück zum Zitat Handel LN, Frenkl TL, Kim YH (2007) Results of cystocele repair: a comparison of traditional anterior colporrhaphy, polypropylene mesh and porcine dermis. J Urol 178:153–156PubMedCrossRef Handel LN, Frenkl TL, Kim YH (2007) Results of cystocele repair: a comparison of traditional anterior colporrhaphy, polypropylene mesh and porcine dermis. J Urol 178:153–156PubMedCrossRef
12.
Zurück zum Zitat Trabuco EC, Klingele CJ, Gebhart JB (2007) Xenograft use in reconstructive pelvic surgery: a review of the literature. Int Urogynecol J 18:555–563CrossRef Trabuco EC, Klingele CJ, Gebhart JB (2007) Xenograft use in reconstructive pelvic surgery: a review of the literature. Int Urogynecol J 18:555–563CrossRef
13.
Zurück zum Zitat Davila GW, Drutz H, Deprest J (2006) Clinical implications of the biology of grafts: conclusions of the 2005 IUGA Grafts Roundtable. Int Urogynecol J 17:S51–S55CrossRef Davila GW, Drutz H, Deprest J (2006) Clinical implications of the biology of grafts: conclusions of the 2005 IUGA Grafts Roundtable. Int Urogynecol J 17:S51–S55CrossRef
14.
Zurück zum Zitat Winters C (2006) Intexen tissue processing and laboratory study. Int Urogynecol J 17:S34–S38CrossRef Winters C (2006) Intexen tissue processing and laboratory study. Int Urogynecol J 17:S34–S38CrossRef
15.
Zurück zum Zitat Sung VW, Rogers RR, Schaeffer JI, Balk EM, Uhlig K, Lau J (2008) Graft use in transvaginal pelvic organ prolapse repair: a systematic review. Obstet Gynecol 112:1131–1142PubMedCrossRef Sung VW, Rogers RR, Schaeffer JI, Balk EM, Uhlig K, Lau J (2008) Graft use in transvaginal pelvic organ prolapse repair: a systematic review. Obstet Gynecol 112:1131–1142PubMedCrossRef
Metadaten
Titel
Biologic grafts for cystocele repair: does concomitant midline fascial plication improve surgical outcomes?
verfasst von
Deborah R. Karp
Thais V. Peterson
Ayman Mahdy
Gamal Ghoniem
Vivian C. Aguilar
G. Willy Davila
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 8/2011
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1408-1

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