Incidence and management of vaginal extrusion of acellular porcine dermis after incontinence and prolapse surgery.
We report our experience with vaginal extrusion of acellular porcine dermis in women undergoing pelvic reconstructive surgery. Over 5 years, 270 patients received a Pelvicol pubovaginal sling (PVS) or prolapse repair using interposition graft. Charts were retrospectively evaluated for evidence of graft extrusion, management, and outcomes. Chi-square analysis was conducted to evaluate the association of extrusion with perioperative variables. Nineteen women (7%) had partial or complete vaginal graft extrusion. After a PVS, 11 of 13 women healed by re-epithelialization and remained continent, while 2 required operative debridement. Four of six patients receiving interposition grafts healed after small incisional separations. Two women underwent additional surgery to address extensive extrusion, and both prolapses recurred. After statistical analysis, vaginal extrusion was significantly associated with PVS and concomitant urethral diverticulectomy. Small incisional separations frequently heal and cause no symptom recurrence. Larger areas of extrusion may require debridement and may contribute to recurrence of symptoms.
Gomelsky
Alex
A
Department of Urology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA. agomel@lsuhsc.edu
Haverkorn
Rashel M
RM
Simoneaux
Walter J
WJ
Bilello
Seth
S
Kubricht
William S
WS
D000328:Adult; D000368:Aged; D000818:Animals; D049109:Cell Proliferation; D020405:Dermis / Q000473:pathology / Q000637:transplantation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013552:Swine; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000473:pathology / Q000601:surgery*; D014596:Uterine Prolapse / Q000473:pathology / Q000601:surgery*