title: Anatomical outcome and quality of life following posterior vaginal wall prolapse repair using collagen xenograft.
abstract: The aim of this study was to evaluate quality of life, sexual function, and anatomical outcome after posterior vaginal wall prolapse repair using a collagen xenograft. Thirty-three patients were evaluated preoperatively and at 6 and 12 months follow-up (FU). Quality of life and sexual function were assessed using a self-reported questionnaire. Prolapse staging was performed using the pelvic organ prolapse quantification system (POPQ). Preoperatively 3 patients had stage I, 26 patients stage II, and 4 patients stage III prolapse of the posterior vaginal wall. Prolapse of the posterior vaginal wall > or = stage II was observed in 7 patients (21%) at the 6-month FU and in 13 patients (39%) at the 12-month FU. Mean point Bp was reduced from -1.1 preoperatively to -2.5 at 6 months FU (p < 0.01) and -1.8 at 12 months FU (p < 0.01). Previous abdominal surgery was associated with a less favorable anatomical outcome (odds ratio: 2.0, 95% confidence interval: 1.5-3.8). There were no significant changes in sexual function or dyspareunia during the 1-year FU. Preoperatively 76% of the patients reported a negative impact on quality of life as a result of genital prolapse. There was a significant improvement in several variables associated with quality of life at 6 and 12 months FU. Posterior vaginal wall prolapse repair using a collagen xenograft was associated with an unsatisfying anatomical outcome at 1-year FU although several quality of life-associated variables affecting psychosocial function were improved. Improvement was not restricted to postoperative restoration of vaginal topography, and previous surgery had a negative effect on anatomical outcome.
authors.affiliation: Division of Obstetrics and Gynecology, Pelvic Floor Center, Danderyd Hospital, Stockholm, Sweden. daniel.altman@ds.se
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
authors.forename: Annika
authors.initials: A
authors.lastname: López
authors.forename: Catharina
authors.initials: C
authors.lastname: Gustafsson
authors.forename: Christian
authors.initials: C
authors.lastname: Falconer
authors.forename: Johan
authors.initials: J
authors.lastname: Nordenstam
authors.forename: Jan
authors.initials: J
authors.lastname: Zetterström
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D003238:Connective Tissue / Q000601:surgery; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D010865:Pilot Projects; D011788:Quality of Life; D012725:Sexual Behavior; D013526:Surgical Mesh; D013536:Suture Techniques; D014183:Transplantation, Heterologous; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000145:classification / Q000601:surgery*; D014621:Vagina / Q000473:pathology* / Q000601:surgery
chemical_list: D001672:Biocompatible Materials; D003094:Collagen