Top

International Urogynecology Journal

Published in:

01-05-2012 | Original Article

Long-term outcomes after native tissue vs. biological graft-augmented repair in the posterior compartment

Authors: Cara L. Grimes, Jasmine Tan-Kim, Emily L. Whitcomb, Emily S. Lukacz, Shawn A. Menefee

Published in: International Urogynecology Journal | Issue 5/2012

Abstract

Introduction and hypothesis

We aimed to compare the outcomes of native tissue vs. biological graft-augmented repair in the posterior compartment. We hypothesized that the addition of graft would result in superior anatomic and functional outcomes.

Methods

A retrospective review of posterior repairs between 2001 and 2008 was performed to compare the anatomic and functional outcomes between native tissue and graft-augmented techniques. Mann–Whitney and chi-square tests were used. Power calculation determined that 32 subjects were needed in each group.

Results

One hundred twenty-four native tissue and 69 graft-augmented repairs were performed with a median follow-up of 35.8 months (range, 6 to 157 months). Anatomic success was similar for native tissue vs. graft (Bp < −1, 86% vs. 80% and Bp ≤ 0, 97% vs. 97%; all p > 0.05). Postoperative splinting and incomplete evacuation was greater in the graft group (splinting, 85% vs. 68%; p = 0.04 and incomplete evacuation, 85% vs. 64%; p = 0.03).

Conclusion

Long-term success of posterior repair is high. Graft augmentation does not appear to improve anatomic or functional outcomes.

Hendrix SL et al (2002) Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol 186(6):1160–1166PubMedCrossRef

Shorvon PJ et al (1989) Defecography in normal volunteers: results and implications. Gut 30(12):1737–1749PubMedCrossRef

Olsen AL et al (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89(4):501–506PubMedCrossRef

Erekson EA et al (2010) The association between stage II or greater posterior prolapse and bothersome obstructive bowel symptoms. Female Pelvic Medicine & Reconstructive Surgery 16(1):59–64CrossRef

Cundiff GW et al (1998) An anatomic and functional assessment of the discrete defect rectocele repair. Am J Obstet Gynecol 179(6 Pt 1):1451–1456, discussion 1456–1457PubMedCrossRef

Porter WE et al (1999) The anatomic and functional outcomes of defect-specific rectocele repairs. Am J Obstet Gynecol 181(6):1353–1358, discussion 1358–1359PubMedCrossRef

Kenton K, Shott S, Brubaker L (1999) Outcome after rectovaginal fascia reattachment for rectocele repair. Am J Obstet Gynecol 181(6):1360–1363, discussion 1363–1364PubMedCrossRef

Singh K, Cortes E, Reid WM (2003) Evaluation of the fascial technique for surgical repair of isolated posterior vaginal wall prolapse. Obstet Gynecol 101(2):320–324PubMedCrossRef

Sardeli C et al (2007) Outcome of site-specific fascia repair for rectocele. Acta Obstet Gynecol Scand 86(8):973–977PubMedCrossRef

10.

Kahn MA, Stanton SL (1997) Posterior colporrhaphy: its effects on bowel and sexual function. Br J Obstet Gynaecol 104(1):82–86PubMedCrossRef

11.

Maher CF et al (2004) Midline rectovaginal fascial plication for repair of rectocele and obstructed defecation. Obstet Gynecol 104(4):685–689PubMedCrossRef

12.

Mellgren A et al (1995) Results of rectocele repair. A prospective study. Dis Colon Rectum 38(1):7–13PubMedCrossRef

13.

Altman D et al (2005) Functional and anatomic outcome after transvaginal rectocele repair using collagen mesh: a prospective study. Dis Colon Rectum 48(6):1233–1241, discussion 1241–1242; author reply 1242PubMedCrossRef

14.

Altman D et al (2006) A three-year prospective assessment of rectocele repair using porcine xenograft. Obstet Gynecol 107(1):59–65PubMedCrossRef

15.

Biehl RC et al (2008) Site-specific rectocele repair with dermal graft augmentation: comparison of porcine dermal xenograft (pelvicol(r)) and human dermal allograft. Surg Technol Int 17:174–180PubMed

16.

Gabriel B et al (2007) Surgical repair of posterior compartment prolapse: preliminary results of a novel transvaginal procedure using a four-armed polypropylene mesh with infracoccygeal and pararectal suspension. Acta Obstet Gynecol Scand Aug 30:1–7

17.

Kohli N, Miklos JR (2003) Dermal graft-augmented rectocele repair. Int Urogynecol J Pelvic Floor Dysfunct 14(2):146–149PubMedCrossRef

18.

Lim YN et al (2007) A long-term review of posterior colporrhaphy with Vypro 2 mesh. Int Urogynecol J Pelvic Floor Dysfunct 18(9):1053–1057PubMedCrossRef

19.

Milani R et al (2005) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. BJOG 112(1):107–111PubMedCrossRef

20.

Sung VW et al (2008) Graft use in transvaginal pelvic organ prolapse repair: a systematic review. Obstet Gynecol 112(5):1131–1142PubMedCrossRef

21.

Taylor GB et al (2008) Posterior repair with perforated porcine dermal graft. Int Braz J Urol 34(1)):84–88, discussion 89–90PubMedCrossRef

22.

Sentilhes L, Descamps P, Marpeau L (2009) Graft use in transvaginal pelvic organ prolapse repair: a systematic review. Obstet Gynecol 113(4):952, author reply 952PubMed

23.

Trabuco EC, Klingele CJ, Gebhart JB (2007) Xenograft use in reconstructive pelvic surgery: a review of the literature. Int Urogynecol J Pelvic Floor Dysfunct 18(5):555–563PubMedCrossRef

24.

Paraiso MF et al (2006) Rectocele repair: a randomized trial of three surgical techniques including graft augmentation. Am J Obstet Gynecol 195(6):1762–1771PubMedCrossRef

25.

Zheng F et al (2005) Improved surgical outcome by modification of porcine dermal collagen implant in abdominal wall reconstruction in rats. Neurourol Urodyn 24(4):362–368PubMedCrossRef

26.

Cole E, Gomelsky A, Dmochowski RR (2003) Encapsulation of a porcine dermis pubovaginal sling. J Urol 170(5):1950PubMedCrossRef

27.

Gandhi S et al (2005) Histopathologic changes of porcine dermis xenografts for transvaginal suburethral slings. Am J Obstet Gynecol 192(5):1643–1648PubMedCrossRef

28.

Barber MD et al (2009) Defining success after surgery for pelvic organ prolapse. Obstet Gynecol 114(3):600–609PubMedCrossRef

29.

Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32(9):920–924PubMedCrossRef

30.

Abramov Y et al (2005) Site-specific rectocele repair compared with standard posterior colporrhaphy. Obstet Gynecol 105(2):314–318PubMedCrossRef

Title: Long-term outcomes after native tissue vs. biological graft-augmented repair in the posterior compartment
Authors: Cara L. Grimes
Jasmine Tan-Kim
Emily L. Whitcomb
Emily S. Lukacz
Shawn A. Menefee
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 5/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-011-1607-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-term outcomes after native tissue vs. biological graft-augmented repair in the posterior compartment

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2012

Does a ring pessary in situ influence the pelvic floor muscle function of women with pelvic organ prolapse when tested in supine?

Uterine prolapse complicating pregnancy and labor: a case report and literature review

Long-term subjective results of tension-free vaginal tape operation for female urinary stress incontinence

Incontinence during intercourse: myths unravelled

The peer review process II: to review and be reviewed

Center-by-center results of a multicenter prospective trial to determine the inter-observer correlation of the simplified POP-Q in describing pelvic organ prolapse