The use of grafts for anterior vaginal prolapse repair: pros and cons.
OBJECTIVE
To review the advantages and disadvantages of ungrafted and grafted methods of anterior vaginal prolapse repair.


RESULTS
Successful correction of anterior vaginal prolapse remains one of the most challenging aspects of pelvic reconstructive surgery. Anterior colporrhaphy is associated with an unacceptably high recurrence rate. Paravaginal repairs are technically more difficult to perform and may be associated with more complications. The low success rate has consequently led to more frequent use of grafts in anterior vaginal prolapse repair. Although retrospective case series of graft-reinforced anterior vaginal prolapse repair shows promising short-term success rates, mesh-related complications are of concern.


CONCLUSIONS
The goal of pelvic surgery should be restoration of anatomic support without deleterious effects on visceral and sexual function. Limited data are available on quality of life and sexual function following both traditional and graft-reinforced anterior vaginal prolapse surgery. Although mesh-reinforced repair is associated with lower short-term anatomic recurrence, the long-term durability and safety of mesh-reinforced repair is unknown. Further research is required to determine whether surgical technique and type of graft used impact surgical outcome and complications.
Nguyen
John N
JN
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Bellflower, California, USA. John.N.Nguyen@kp.org
D052858:Cystocele; D005260:Female; D006801:Humans; D010388:Pelvis / Q000601:surgery*; D011183:Postoperative Complications; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013526:Surgical Mesh; D019737:Transplants; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*