Factors influencing success of pelvic organ prolapse repair using porcine dermal implant Pelvicol.
OBJECTIVE
To evaluate factors influencing pelvic organ prolapse (POP) recurrence after repair surgery with a porcine dermal collagen implant (Pelvicol).


METHODS
From December 2003 to August 2005, 78 patients with mainly stage 3 pelvic organ prolapse by the Pelvic Organ Prolapse Quantification (POP-Q) system underwent vaginal repair using porcine dermal implant. Assessments were made preoperatively and at 6 weeks and one year follow-up. These included physical examination with POP-Q, Incontinence Impact Questionnaire, Urogenital Distress Inventory and the Defaecatory Distress Inventory and questions from the Patient Global Impression of Improvement. Data were recorded on changes in functional status, mesh erosion and adverse events. Procedural success was defined as POP-Q stage 0/1.


RESULTS
71 patients returned for one year follow-up. The overall cure rate was 74.6%. The chance of a successful operation in the younger group was significantly higher than in the older group (OR: 7.5; 95% CI 1.38, 40.69), but this effect is lower and no longer significant after adjusting for compartment (post, anterior, post+anterior) (adjusted OR: 5.5; 95% CI 0.92, 32.6).


CONCLUSIONS
A low complication rate and satisfactory overall results were observed in a group of women after POP repair surgery with Pelvicol. Whether these results are better or worse than with conventional surgery or non-resorbable mesh implantation is unclear and can only be determined in a randomized controlled trial. There was a strong tendency towards better results in the younger women than in the older women, but the reason for this phenomenon is unclear.
de Boer
T A
TA
Department of Obstetrics and Gynaecology, Amphia Hospital, Breda, The Netherlands. T.deBoer@obgyn.umcn.nl
Gietelink
D A
DA
Hendriks
J C M
JC
Vierhout
M E
ME
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D019919:Prosthesis Implantation; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D016038:Skin Transplantation; D053825:Suburethral Slings; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D016896:Treatment Outcome