Treatment of genital prolapse by hammock using porcine skin collagen implant (Pelvicol).
BACKGROUND
To assess the feasibility and efficacy of the hammock using a porcine skin collagen (Pelvicol) implant for the treatment of genital prolapse by the vaginal route. A total of 47 women with Stage III or IV genital prolapse underwent surgical treatment with porcine skin collagen implantation using anterior transobturator and posterior bilateral sacrospinous fixations. Genital prolapse treatment was combined with hysterectomy in 34 patients (72%).


METHODS
Porcine skin collagen implantation was feasible in every case. The surgical procedure lasted a median of 90 minutes (range 80 to 150). No vessel injuries, one bladder injury, and one rectal injury not requiring additional surgery occurred. One pararectal hematoma required a second procedure. The median follow-up was 24.6 +/- 8.5 months (range 6 to 42). No rejection of the porcine grafts occurred. Of the 47 women, 39 (83%) had optimal anatomic results, 5 had asymptomatic Stage I prolapse, and 2 had Stage II prolapse. The subjective cure rate was 93.6% (44 of 47 patients). The postoperative scores for lifestyle and urinary discomfort improved significantly after the procedure (P < 0.0001 and P < 0.0002, respectively). Of the 18 patients who were sexually active, an improvement in sexual discomfort occurred (P = 0.04).


CONCLUSIONS
These short-term results suggest that hammock using porcine skin collagen implantation by the transobturator route and bilateral sacrospinous fixation is a safe and effective treatment for genital prolapse.
David-Montefiore
Emmanuel
E
Service de Gynécologie, Obstétrique et Médecine de la Reproduction, Hôpital Tenon, Université Saint-Antoine, Assistance Publique des Hôpitaux de Paris, Paris, France.
Barranger
Emmanuel
E
Dubernard
Gil
G
Detchev
Romain
R
Nizard
Victor
V
Daraï
Emile
E
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D003094:Collagen; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016038:Skin Transplantation; D013552:Swine; D013520:Urologic Surgical Procedures / Q000379:methods; D014596:Uterine Prolapse / Q000601:surgery*
D003094:Collagen