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.
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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)
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Topics |
- Aged
- Bioprosthesis
- Cystocele
(surgery)
- Fasciotomy
- Female
- Humans
- Middle Aged
- Patient Satisfaction
- Recurrence
- Retrospective Studies
- Sexual Behavior
- Treatment Outcome
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