[Laparoscopic sacral colpopexy: comparison of nonresorbable prosthetic tape (Mersuture) and a SIS collagen matrix (Surgisis ES)].
OBJECTIVE
Surgical repair of pelvic prolapse by sacral colpopexy classically uses nonresorbable prosthetic tape. Infectious or erosive complications can sometimes occur and are often difficult to treat. The authors propose the use of a xenogeneic biomaterial composed of an extracellular collagen matrix: SIS (Small Intestinal Submucosa).


METHODS
Fifty seven laparoscopic sacral colpopexies were performed between November 2001 and December 2003: 14 using SIS tape (anterior + posterior in 13 cases, anterior only in 1 case) and 43 using Mersuture PETP nonresorbable tape (anterior + posterior in 31 cases, anterior only in 10 cases and posterior only in 2 cases). Suburethral support was associated with sacral colpopexy in 40 patients with stress urinary incontinence.


RESULTS
With a mean follow-up of 15.3 months (range: 3-24 months), one case of recurrent prolapse was observed after 7 months in the SIS group. For the PETP group (mean follow-up: 14.6 months, range: 5-25 months) 3 cases of recurrent prolapse were observed at the third postoperative month. Two cases of refractory constipation were observed in the PETP group versus one in the SIS group. The mean operating time was 100 (1 tape) and 120 minutes (2 tapes) with difference according to the type of material. The mean hospital stay was 4.8 days. No infectious complication was observed in either group.


CONCLUSIONS
These encouraging results suggest that SIS can constitute an alternative to nonresorbable tape in sacral colpopexy. It appears to be well tolerated in the medium-term. The functional characteristics of SIS, replaced within 6 months by newly formed connective tissue, suggest a lower long-term risk of infection and erosion.
Grynberg
Michaël
M
Département d 'Urologie-Andrologie, Hôpital Robert Debré, Reims, France.
Dedecker
Frédéric
F
Staerman
Frédéric
F
D000328:Adult; D000368:Aged; D003094:Collagen; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011092:Polyethylene Glycols; D011093:Polyethylene Terephthalates; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012189:Retrospective Studies; D012447:Sacrum; D014596:Uterine Prolapse / Q000601:surgery*
D011093:Polyethylene Terephthalates; C475920:polyethylene terephthalate glycol; D011092:Polyethylene Glycols; D003094:Collagen