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International Urogynecology Journal

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01-10-2009 | Original Article

Arcus-anchored acellular dermal graft compared to anterior colporrhaphy for stage II cystoceles and beyond

Authors: Sylvia M. Botros, Peter K. Sand, Jennifer L. Beaumont, Yoram Abramov, Jay James Miller, Roger P. Goldberg

Published in: International Urogynecology Journal | Issue 10/2009

Abstract

Introduction and hypothesis

The aim of this study is to compare acellular dermal matrix to standard colporrhaphy for cystocele repair.

Methods

One hundred two patients with greater than or equal to stage II anterior prolapse (Aa or Ba 0) who underwent anterior colporrhaphy with acellular dermal implant attached to the arcus between October 2003 and February 2007 were compared to 89 controls who received standard anterior colporrhaphy. Objective recurrence was defined as greater than or equal to stage II (Aa or Ba −1).

Results

The dermal graft and colporrhaphy groups were comparable in age, parity, body mass index, and concomitant surgeries except hysteropexy and hysterectomy. Regression was performed for possible confounders. Postoperatively, 14 (19%) recurrences were identified in the dermal graft group vs. 26 (43%) in the colporrhaphy group (p = 0.004). Two patients underwent reoperations for cystocele recurrence in the study group vs. four in the control group. Time to normal voiding, subjective stress urinary incontinence, estimated blood loss, and length of hospital stay did not differ between groups.

Conclusion

Dermal acellular matrix provides benefit over standard colporrhaphy.

Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1304PubMedCrossRef

Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ, Goldberg R (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1362PubMedCrossRef

Lazarou G, Powers K, Pena C, Bruck L, Mikhail MS (2005) Inflammatory reaction following bovine pericardium graft augmentation for posterior vaginal wall defect repair. Int Urogynecol J Pelvic Floor Dysfunct 16:242–244PubMedCrossRef

Le TH, Kon L, Bhatia NN, Ostergard DR (2007) Update on the utilization of grafts in pelvic reconstruction surgeries. Curr Opin Obstet Gynecol 19:480–489PubMedCrossRef

Herschorn S (2007) The use of biological and synthetic materials in vaginal surgery for prolapse. Curr Opin Urol 17:408–414PubMedCrossRef

Espinosa-de-los-Monteros A, de la Torre JI, Marrero I, Andrades P, Davis MR, Vásconez LO (2007) Utilization of human cadaveric acellular dermis for abdominal hernia reconstruction. Ann Plast Surg 58:264–267PubMedCrossRef

Buinewicz B, Rosen B (2004) Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair. Ann Plast Surg 52:188–194PubMedCrossRef

Wainwright DJ (1995) Use of an acellular allograft dermal matrix (AlloDerm) in the management of full thickness burns. Burns 21:243–248PubMedCrossRef

Wainwright D, Madden M, Luterman A et al (1996) Clinical evaluation of an acellular allograft dermal matrix in full-thickness burns. J Burn Care Rehabil 17:124–136PubMedCrossRef

10.

Constantino PD, Govindaraj S, Hiltzik DH et al (2001) Acellular dermis for facial soft tissue augmentation. Arch Facial Plast Surg 3:38–43

11.

Jones FR, Schwartz BM, Silverstein P (1996) Use of a nonimmunogenic acellular dermal allograft for soft-tissue augmentation: a preliminary report. Aesthet Surg Q 16:196–201

12.

Abenavoli FM, Corelli R (2001) About AlloDerm. Plast Reconstr Surg 108:2175–2176PubMedCrossRef

13.

Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRef

14.

Shull BL (1999) Pelvic organ prolapse: anterior, superior, and posterior vaginal segment defects. Am J Obstet Gynecol 181:6–11 ReviewPubMedCrossRef

15.

Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S (2008) Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn 27:3–12 ReviewPubMedCrossRef

16.

Wong AK, Schonmeyer BH, Singh P, Carlson DL, Li S, Mehrara BJ (2008) Histologic analysis of angiogenesis and lymphangiogenesis in acellular human dermis. Plast Reconstr Surg 121:1144–1152PubMedCrossRef

17.

Gandhi S, Kubba LM, Abramov Y, Botros SM, Goldberg RP, Victor TA, Sand PK (2005) Histopathologic changes of porcine dermis xenografts for transvaginal suburethral slings. Am J Obstet Gynecol 192:1643–1648PubMedCrossRef

18.

Gandhi S, Goldberg RP, Kwon C, Koduri S, Beaumont JL, Abramov Y, Sand PK (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

19.

Clemons JL, Myers DL, Aguilar VC, Arya LA (2003) Vaginal paravaginal repair with an AlloDerm graft. Am J Obstet Gynecol 189:1612–1619PubMedCrossRef

20.

Chung SY, Franks M, Smith CP, Lee JY, Lu SH, Chancellor M (2002) Technique of combined pubovaginal sling and cystocele repair using a single piece of cadaveric dermal graft. Urology 59:538–541PubMedCrossRef

21.

Verdeja AM, Elkins TE, Odoi A et al (1995) Transvaginal sacrospinous colpopexy: anatomic landmarks to be aware of to minimize complications. Am J Obstet Gynecol 173:1468–1469PubMedCrossRef

Title: Arcus-anchored acellular dermal graft compared to anterior colporrhaphy for stage II cystoceles and beyond
Authors: Sylvia M. Botros
Peter K. Sand
Jennifer L. Beaumont
Yoram Abramov
Jay James Miller
Roger P. Goldberg
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 10/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-0933-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Arcus-anchored acellular dermal graft compared to anterior colporrhaphy for stage II cystoceles and beyond

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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