Display Settings:

Format

Send to:

Choose Destination
Int Urogynecol J. 2011 May;22(5):601-9. doi: 10.1007/s00192-010-1346-3. Epub 2011 Jan 11.

Site-specific prolapse surgery. II. Vaginal paravaginal repair augmented with either synthetic mesh or remodelling xenograft.

Author information

  • 1School of Rural Medicine, Armidale, Australia. richard_reid@dbgyn.com

Abstract

INTRODUCTION AND HYPOTHESIS:

This study aims to answer the question, "Does tissue augmentation improve the mechanical repair of displacement cystourethrocoele?"

METHODS:

A retrospective cohort study comparing 108 bridging graft vaginal paravaginal repairs (89 tissue-inductive xenografts and 19 polypropylene mesh) to 59 native tissue historical controls was conducted. Main outcome measures were same-site prolapse recurrence and time to failure. Initial reliability was evaluated by chi-squared test, 10-year durability by Kaplan-Meier survival analysis and risk factors by Cox regression.

RESULTS:

Late recurrence was 17.7% lower with augmentation (logrank test χ (2) = 8.4, p value = 0.0038 < 0.05, adjusted regression analysis χ (2) = 2.94; p value = 0.0866 <0.10), implicating collagen degeneration in repair failure.

CONCLUSIONS:

Rebuilding the pubocervical septum, from arcus to arcus and pubic ramus to pericervical ring, satisfies the mechanical but not the metabolic hernia principles. Bridging grafts simplify technical repair (reducing prolapse persistence from 10.2% to 4.6%), and also rejuvenate adjacent connective tissue (reducing late recurrence from 22.6% to 4.9%).

PMID:
21222113
[PubMed - indexed for MEDLINE]
PMCID:
PMC3072475
Free PMC Article

Images from this publication.See all images (1)Free text

Fig. 1
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Springer Icon for PubMed Central
    Loading ...
    Write to the Help Desk