Outcomes with porcine graft placement in the anterior vaginal compartment in patients who undergo high vaginal uterosacral suspension and cystocele repair.
OBJECTIVE
The purpose of this study was to prospectively assess the cases of patients who had undergone a high uterosacral suspension and anterior repair with anterior compartment placement of porcine dermis graft.


METHODS
Thirty-six patients who underwent transvaginal high uterosacral suspension and cystocele repair with graft augmentation from June 2001 to July 2004 were identified from the University of Alabama at Birmingham Genitourinary Disorders database. Analysis included the pre- and postoperative Pelvic Organ Prolapse Quantification examinations and incontinence impact questionnaire-7/urogenital distress inventory-6.


RESULTS
Mean Pelvic Organ Prolapse Quantification Ba improved from +3.3 +/- 2.2 cm to -0.6 +/- 1.7 cm (P < .01). Postoperative Ba was prolapse stage II or greater in 50% of subjects. Mean incontinence impact questionnaire-7 scores improved from 36.2 +/- 31.9 to 15.6 +/- 26.2 (P < .01), as did mean urogenital distress inventory-6 scores from 58.2 +/- 26.8 to 23.8 +/- 22.6 (P < .01).


CONCLUSIONS
Significant improvements in Pelvic Organ Prolapse Quantification measures, urinary symptoms, and the impact of incontinence were seen after the operation. However, a significant proportion of patients had Pelvic Organ Prolapse Quantification stage II prolapse or greater, which made it unclear whether graft use confers a significant advantage.
Wheeler
Thomas L
TL
Division of Medical Gynecology, Department of Obstetrics and Gynecology, University of Alabama, Birmingham, AL 35249-7333, USA. tlwheeler@uabmc.edu
Richter
Holly E
HE
Duke
Angela G
AG
Burgio
Kathryn L
KL
Redden
David T
DT
Varner
R Edward
RE
D000368:Aged; D000818:Animals; D001705:Bioprosthesis; D020405:Dermis; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012447:Sacrum; D012720:Severity of Illness Index; D016038:Skin Transplantation; D013552:Swine; D014183:Transplantation, Heterologous; D016042:Transplantation, Heterotopic; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000503:physiopathology / Q000601:surgery*; D014549:Urinary Incontinence / Q000503:physiopathology; D014596:Uterine Prolapse / Q000503:physiopathology / Q000601:surgery*; D014599:Uterus / Q000601:surgery; D014621:Vagina / Q000601:surgery*