The effectiveness and complications of graft materials used in vaginal prolapse surgery.
OBJECTIVE
In the last decade, there has been an increase in the use of graft materials in vaginal prolapse surgery. Most of the evidence available is based on case studies produced by the manufacturers, with few randomized controlled trials. In October 2008, the United States Food and Drug Administration issued a safety warning on the use of grafts in vaginal surgery. It has been suggested that there is a greater need to review the evidence on the effectiveness and complication of grafts.


RESULTS
This article explores the recent literature on the use of grafts in vaginal prolapse surgery. The use of grafts versus standard techniques for vaginal wall repair is examined, looking at subjective and objective cure as well as complications.


CONCLUSIONS
Despite the wide use of grafts in vaginal prolapse surgery, there is still a need for level 1 evidence to support their use, with long-term follow-up of 3 or 5 years. There is, however, good evidence to support the use of grafts in suburethral slings and abdominal sacrocolpopexy.
Foon
Richard
R
Department of Obstetrics and Gynecology, Southmead Hospital, Westbury-on-Trym, Bristol, UK. r.p.foon@talk21.com
Smith
Phillip
P
D020341:Absorbable Implants / Q000009:adverse effects; D001672:Biocompatible Materials / Q000009:adverse effects*; D052858:Cystocele; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012086:Reoperation; D053825:Suburethral Slings / Q000009:adverse effects*; D014182:Transplantation, Autologous; D019737:Transplants; D014596:Uterine Prolapse / Q000601:surgery*
D001672:Biocompatible Materials