Grade 4 cystocele repair using four-defect repair and porcine xenograft acellular matrix (Pelvicol): Outcome measures using SEAPI

Leboeuf, Line; Miles, Ruth Ann; Kim, Sandy S.; Gousse, Angelo E.

doi:10.1016/j.urology.2004.03.044

Cited by 41 publications

(18 citation statements)

References 15 publications

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“…Four studies used absorbable synthetic mesh, 13,17,18,59 14 studies used biological graft, [13][14][15]22,24,25,30,33,35,50-52,57,60 1 study used combined mesh/ graft, 38 and 14 studies used nonabsorbable synthetic mesh. 19,20,22,23,29,33,34,37,44,46,49,55,56,58 The median follow-up time was 14 months (range 1-38 months).…”

Section: Anterior Vaginal Wall Prolapse Repairmentioning

confidence: 99%

Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta‐analysis

Jia

Glazener

Mowatt

et al. 2008

BJOG

192

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Background The efficacy and safety of mesh/graft in surgery for anterior or posterior pelvic organ prolapse is uncertain.Objectives To systematically review the efficacy and safety of mesh/graft for anterior or posterior vaginal wall prolapse surgery.Search strategy Electronic databases and conference proceedings were searched, experts and manufacturers contacted, and reference lists of retrieved papers scanned.Selection criteria Randomised controlled trials (RCTs), nonrandomised comparative studies, registries, case series involving at least 50 women, and RCTs published as conference abstracts from 2005 onwards.Data collection and analysis One reviewer screened titles/ abstracts, undertook data extraction, and assessed study quality. Data analysis was conducted for three subgroups: anterior, posterior, and anterior and/or posterior repair (not reported separately).Results Forty-nine studies involving 4569 women treated with mesh/graft were included. Study quality was generally high. Median follow up was 13 months (range 1-51 months). In anterior repair, there was short-term evidence that mesh/graft (any type) significantly reduced objective prolapse recurrence rates compared with no mesh/graft (relative risk 0.48, 95% CI 0.32-0.72). Nonabsorbable synthetic mesh had a significantly lower objective prolapse recurrence rate (8.8%, 48/548) than absorbable synthetic mesh (23.1%, 63/273) and biological graft (17.9%, 186/1041), but a higher erosion rate (10.2%, 68/666) than absorbable synthetic mesh (0.7%, 1/147) and biological graft (6.0%, 35/581). There was insufficient information to compare any of the other outcomes regardless of prolapse type.Conclusions Evidence for most outcomes was too sparse to provide meaningful conclusions. Rigorous long-term RCTs are required to determine the comparative efficacy of using mesh/graft.

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Section: Anterior Vaginal Wall Prolapse Repairmentioning

confidence: 99%

Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta‐analysis

Jia

Glazener

Mowatt

et al. 2008

BJOG

192

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“…Published reports of porcine dermis interposition grafts for high-grade prolapse repairs have been equally infrequent. There was one incisional separation out of a combined 115 women in two separate reports (1%) [13,14]. She healed with conservative treatment and did not require additional surgery.…”

Section: Discussionmentioning

confidence: 96%

“…In addition, significant rates of extrusion and infectious complications have been identified with certain xenografts, including bovine pericardium and eightply porcine small intestinal submucosa [9,10]. Despite the longstanding availability of acellular porcine dermis, there have been relatively few published reports of surgical outcomes after PVS and porcine dermis interposition grafts for prolapse repair [11][12][13][14]. As such, descriptions of complications and their subsequent management have been rare.…”

Section: Discussionmentioning

confidence: 99%

Incidence and management of vaginal extrusion of acellular porcine dermis after incontinence and prolapse surgery

et al. 2007

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We report our experience with vaginal extrusion of acellular porcine dermis in women undergoing pelvic reconstructive surgery. Over 5 years, 270 patients received a Pelvicol pubovaginal sling (PVS) or prolapse repair using interposition graft. Charts were retrospectively evaluated for evidence of graft extrusion, management, and outcomes. Chi-square analysis was conducted to evaluate the association of extrusion with perioperative variables. Nineteen women (7%) had partial or complete vaginal graft extrusion. After a PVS, 11 of 13 women healed by re-epithelialization and remained continent, while 2 required operative debridement. Four of six patients receiving interposition grafts healed after small incisional separations. Two women underwent additional surgery to address extensive extrusion, and both prolapses recurred. After statistical analysis, vaginal extrusion was significantly associated with PVS and concomitant urethral diverticulectomy. Small incisional separations frequently heal and cause no symptom recurrence. Larger areas of extrusion may require debridement and may contribute to recurrence of symptoms.

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“…Both synthetic and biologic materials have been used in nearly every facet of reconstructive pelvic surgery, including pubovaginal slings and anterior and posterior repairs, as well as abdominal sacral colpopexy (1)(2)(3)(4)(5)(6). The purpose of using grafts is to provide a tissue scaffold for ingrowth to occur and improve tissue strength, thereby improving the longevity of the surgical repairs.…”

Section: Introductionmentioning

confidence: 99%

Posterior repair with perforated porcine dermal graft

et al. 2008

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Objective: To compare postoperative vaginal incision separation and healing in patients undergoing posterior repair with perforated porcine dermal grafts with those that received grafts without perforations. Secondarily, the tensile properties of the perforated and non-perforated grafts were measured and compared. Materials and Methods: This was a non-randomized retrospective cohort analysis of women with stage II or greater rectoceles who underwent posterior repair with perforated and non-perforated porcine dermal grafts (Pelvicol TM CR Bard Covington, GA USA). The incidence of postoperative vaginal incision separation (dehiscence) was compared. A secondary analysis to assess graft tensile strength, suture pull out strength, and flexibility after perforation was performed using standard test method TM 0133 and ASTM bending and resistance protocols. Results: Seventeen percent of patients (21/127) who received grafts without perforations developed vaginal incision dehiscence compared to 7% (5/71) of patients who received perforated grafts (p = 0.078). Four patients with vaginal incision dehiscence with non-perforated grafts required surgical revision to facilitate healing. Neither tensile strength or suture pull out strength were significantly different between perforated and non-perforated grafts (p = 0.81, p = 0.29, respectively). There was no difference in the flexibility of the two grafts (p = 0.20). Conclusion: Perforated porcine dermal grafts retain their tensile properties and are associated with fewer vaginal incision dehiscences.

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Grade 4 cystocele repair using four-defect repair and porcine xenograft acellular matrix (Pelvicol): Outcome measures using SEAPI

Cited by 41 publications

References 15 publications

Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta‐analysis

Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta‐analysis

Incidence and management of vaginal extrusion of acellular porcine dermis after incontinence and prolapse surgery

Posterior repair with perforated porcine dermal graft

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