title: Arcus-anchored acellular dermal graft compared to anterior colporrhaphy for stage II cystoceles and beyond.
abstract: 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.
authors.affiliation: Evanston Northwestern Healthcare, Division of Urogynecology, Feinberg School of Medicine, Northwestern University, Suite 730, Evanston, IL 60201, USA. sbotros@northshore.org
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Botros
authors.forename: Peter K
authors.initials: PK
authors.lastname: Sand
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.forename: Yoram
authors.initials: Y
authors.lastname: Abramov
authors.forename: Jay James
authors.initials: JJ
authors.lastname: Miller
authors.forename: Roger P
authors.initials: RP
authors.lastname: Goldberg
mesh_terms: 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