Biologic grafts for cystocele repair: does concomitant midline fascial plication improve surgical outcomes?
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 transobturat...
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| Published in | International Urogynecology Journal Vol. 22; no. 8; pp. 985 - 990 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
Springer-Verlag
01.08.2011
Springer Nature B.V |
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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. |
|---|---|
| AbstractList | INTRODUCTION AND HYPOTHESISThis study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication. METHODSWomen 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. RESULTSBetween 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). CONCLUSIONSWhen 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. 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. This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication. 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. 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). 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.[PUBLICATION ABSTRACT] This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication. 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. 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). 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. |
| Author | Aguilar, Vivian C. Peterson, Thais V. Ghoniem, Gamal Mahdy, Ayman Karp, Deborah R. Davila, G. Willy |
| Author_xml | – sequence: 1 givenname: Deborah R. surname: Karp fullname: Karp, Deborah R. organization: Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd – sequence: 2 givenname: Thais V. surname: Peterson fullname: Peterson, Thais V. organization: Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd – sequence: 3 givenname: Ayman surname: Mahdy fullname: Mahdy, Ayman organization: Department of Urology, Cleveland Clinic Florida – sequence: 4 givenname: Gamal surname: Ghoniem fullname: Ghoniem, Gamal organization: Department of Urology, Cleveland Clinic Florida – sequence: 5 givenname: Vivian C. surname: Aguilar fullname: Aguilar, Vivian C. organization: Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd – sequence: 6 givenname: G. Willy surname: Davila fullname: Davila, G. Willy email: davilag@ccf.org organization: Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/21484371$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1007/s00192-006-0099-5 10.1007/s00192-009-1061-0 10.1016/j.juro.2007.03.041 10.1097/AOG.0b013e3181a81b41 10.1016/j.juro.2006.08.100 10.1007/s00192-006-0288-2 10.1007/s00192-006-0108-8 10.1016/S0002-9378(96)70243-0 10.1016/j.ajog.2005.02.061 10.1002/14651858.CD004014.pub3 10.1097/AOG.0b013e3181cbca4d 10.1007/s00192-008-0660-5 10.1097/AOG.0b013e3181898ba9 10.1007/s00192-008-0732-6 |
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| Keywords | Porcine dermis graft Bioprosthesis Pelvic reconstructive surgery Pelvic organ prolapse Cystocele Biologic grafts |
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| PublicationSubtitle | Including Pelvic Floor Dysfunction |
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This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying... This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication. Women... This study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical fascia plication. Women... INTRODUCTION AND HYPOTHESISThis study aims to compare the efficacy of porcine graft-augmented anterior prolapse repair with and without underlying pubocervical... |
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| SubjectTerms | Aged Bioprosthesis Cystocele - surgery Fasciotomy Female Gynecology Humans Medicine Medicine & Public Health Middle Aged Original Article Patient Satisfaction Recurrence Retrospective Studies Sexual Behavior Treatment Outcome Urology |
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| Title | Biologic grafts for cystocele repair: does concomitant midline fascial plication improve surgical outcomes? |
| URI | https://link.springer.com/article/10.1007/s00192-011-1408-1 https://www.ncbi.nlm.nih.gov/pubmed/21484371 https://www.proquest.com/docview/875618226 https://search.proquest.com/docview/876187329 |
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