title: A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse.
abstract: 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.
authors.affiliation: Evanston Continence Center, Northwestern University Feinberg School of Medicine, Ill, USA. homeysan@yahoo.com
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gandhi
authors.forename: Roger P
authors.initials: RP
authors.lastname: Goldberg
authors.forename: Christina
authors.initials: C
authors.lastname: Kwon
authors.forename: Sumana
authors.initials: S
authors.lastname: Koduri
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.forename: Yoram
authors.initials: Y
authors.lastname: Abramov
authors.forename: Peter K
authors.initials: PK
authors.lastname: Sand
mesh_terms: 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*
chemical_list: D012997:Solvents