Arcus-anchored acellular dermal graft compared to anterior colporrhaphy for stage II cystoceles and beyond.
OBJECTIVE
The aim of this study is to compare acellular dermal matrix to standard colporrhaphy for cystocele repair.


METHODS
One hundred two patients with greater than or equal to stage II anterior prolapse (Aa or Ba 0) who underwent anterior colporrhaphy with acellular dermal implant attached to the arcus between October 2003 and February 2007 were compared to 89 controls who received standard anterior colporrhaphy. Objective recurrence was defined as greater than or equal to stage II (Aa or Ba -1).


RESULTS
The dermal graft and colporrhaphy groups were comparable in age, parity, body mass index, and concomitant surgeries except hysteropexy and hysterectomy. Regression was performed for possible confounders. Postoperatively, 14 (19%) recurrences were identified in the dermal graft group vs. 26 (43%) in the colporrhaphy group (p = 0.004). Two patients underwent reoperations for cystocele recurrence in the study group vs. four in the control group. Time to normal voiding, subjective stress urinary incontinence, estimated blood loss, and length of hospital stay did not differ between groups.


CONCLUSIONS
Dermal acellular matrix provides benefit over standard colporrhaphy.
Botros
Sylvia M
SM
Evanston Northwestern Healthcare, Division of Urogynecology, Feinberg School of Medicine, Northwestern University, Suite 730, Evanston, IL 60201, USA. sbotros@northshore.org
Sand
Peter K
PK
Beaumont
Jennifer L
JL
Abramov
Yoram
Y
Miller
Jay James
JJ
Goldberg
Roger P
RP
D000368:Aged; D015331:Cohort Studies; D020884:Colpotomy / Q000379:methods*; D052858:Cystocele / Q000601:surgery*; D020405:Dermis / Q000637:transplantation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome