Long-term outcome of abdominal sacrocolpopexy using xenograft compared with synthetic mesh.
OBJECTIVE
To assess the clinical outcome after abdominal sacrocolpopexy using a porcine dermal graft compared with a synthetic mesh.


METHODS
Patients with vaginal vault prolapse Stage II or worse (Baden-Walker staging), underwent sacrocolpopexy using a synthetic mesh (n = 25) or porcine collagen graft (n = 27). The subjective outcome was measured using validated questionnaires.


RESULTS
The mean clinical follow-up from surgery was 7.1 months for the xenograft compared with 7.4 months for the synthetic cohort. At clinical follow-up, vaginal vault prolapse Stage II was present in 8 (29%) of 27 patients in the xenograft cohort and 6 (24%) of 25 patients in the synthetic mesh cohort (no significant difference). The mean follow-up from surgery to survey was 2.5 years in the xenograft cohort and 4.3 years in the synthetic cohort. None of the patients in either cohort had undergone a secondary sacrocolpopexy. No significant differences were found between the cohorts regarding surgical morbidity other than more patients experiencing fever for 1 to 3 days in the xenograft cohort (P < 0.001). No significant differences were found in lower urinary tract symptoms, anorectal symptoms, or quality-of-life variables between the two cohorts.


CONCLUSIONS
Abdominal sacrocolpopexy using a porcine dermal graft was comparable to synthetic mesh in terms of subjective and anatomic outcomes at mid to long-term follow-up.
Pelvic Floor Center, Danderyd Hospital, Stockholm, Sweden. daniel.altman@ds.se
Daniel
D
Altman
Bo
B
Anzen
Sophia
S
Brismar
Annika
A
Lopez
Jan
J
Zetterström
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002584:Cervix Uteri; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012447:Sacrum; D016038:Skin Transplantation; D013526:Surgical Mesh; D013552:Swine; D013997:Time Factors; D014183:Transplantation, Heterologous; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods; D014596:Uterine Prolapse / Q000601:surgery*