A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse.
OBJECTIVE
This study was undertaken to compare outcomes after anterior colporrhaphy with and without a solvent dehydrated cadaveric fascia lata graft.


METHODS
A total of 162 women were enrolled in a prospective, randomized trial that evaluated the impact of a solvent dehydrated cadaveric fascia lata patch on recurrent anterior vaginal prolapse. Subjects were randomly assigned to standard colporrhaphy with or without a patch. Before and after surgery, subjects were evaluated by both the Baden-Walker and pelvic organ prolapse quantification systems. "Failure" was defined as stage II anterior wall prolapse or worse.


RESULTS
Of 154 women randomly assigned (76 patch: 78 no patch), all underwent surgery and 153 (99%) returned for follow-up. Sixteen women (21%) in the patch group and 23 (29%) in the control group experienced recurrent anterior vaginal wall prolapse (P = .229). Only 26% of all recurrences were symptomatic. Concomitant transvaginal Cooper's ligament sling procedures were associated with a dramatic decrease in recurrent prolapse (odds ratio [OR] 0.105 , P < .0001).


CONCLUSIONS
Solvent dehydrated fascia lata as a barrier does not decrease recurrent prolapse after anterior colporrhaphy. Transvaginal bladder neck slings were associated with a significant reduction in the risk of recurrent anterior wall prolapse.
Gandhi
Sanjay
S
Evanston Continence Center, Northwestern University Feinberg School of Medicine, Ill, USA. homeysan@yahoo.com
Goldberg
Roger P
RP
Kwon
Christina
C
Koduri
Sumana
S
Beaumont
Jennifer L
JL
Abramov
Yoram
Y
Sand
Peter K
PK
D000368:Aged; D003681:Dehydration; D005206:Fascia Lata / Q000187:drug effects* / Q000378:metabolism / Q000637:transplantation*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011446:Prospective Studies; D055502:Secondary Prevention; D012997:Solvents / Q000494:pharmacology*; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery*
D012997:Solvents