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

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.

• Authors: Deborah R Karp, Thais V Peterson, Ayman Mahdy, Gamal Ghoniem, Vivian C Aguilar, G Willy Davila
• Journal: International urogynecology journal (Int Urogynecol J) Vol. 22 Issue 8 Pg. 985-90 (Aug 2011) ISSN: 1433-3023 [Electronic] England
• PMID: 21484371 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Bioprosthesis
• Cystocele (surgery)
• Fasciotomy
• Female
• Humans
• Middle Aged
• Patient Satisfaction
• Recurrence
• Retrospective Studies
• Sexual Behavior
• Treatment Outcome