title: Vaginal paravaginal repair with porcine small intestine submucosa: midterm outcomes.
abstract: OBJECTIVE
  : This study aimed to determine the midterm efficacy of porcine small intestine submucosa for paravaginal repairs of anterior vaginal prolapse.
  
  
  METHODS
  : One hundred five women underwent repairs between 2003 and 2006 and met our inclusion criteria. Women were invited to return for a pelvic examination and to fill out validated questionnaires. Objective failure was defined as anterior prolapse recurrence at or beyond the hymen.
  
  
  RESULTS
  : Fifty-nine women (56%) were available for follow-up. Median age of patients was 60 years (range, 26-80 years) and 83% had a parity of 2 or more. Ninety-seven percent of patients had a preoperative prolapse stage of 2 or more. Follow-up ranged from 1 to 5 years (median, 27.5 months; interquartile range, 14.5). The most common postoperative complication was transient voiding dysfunction (23.7%). Objective cure rate was 68.8%. A positive change in bladder, vaginal, and bowel symptoms (a little better, much better, or very much better) was reported by 69.5%, 59.3%, and 25.5% of women, respectively. Thirty-one women (52.5%) were sexually active at postoperative follow-up. Only 4 women (6.8%) were not sexually active because of pelvic symptoms. Dyspareunia was reported by 8.3% of the 48 women who returned for a clinic follow-up. Twenty-four women (40.7%) were not sexually active postoperatively, for reasons unrelated to their surgeries.
  
  
  CONCLUSIONS
  : Vaginal paravaginal repair using porcine xenograft is a safe procedure whose long-term efficacy needs further evaluation through prospective trials.
authors.affiliation: From the *University of British Columbia, Vancouver, British Columbia; †University of Calgary, Calgary, Alberta; and ‡University of Victoria, Victoria, British Columbia, Canada.
authors.forename: Roxana
authors.initials: R
authors.lastname: Geoffrion
authors.forename: Magnus
authors.initials: M
authors.lastname: Murphy
authors.forename: Magali
authors.initials: M
authors.lastname: Robert
authors.forename: Colin
authors.initials: C
authors.lastname: Birch
authors.forename: Sue
authors.initials: S
authors.lastname: Ross
authors.forename: Selphee
authors.initials: S
authors.lastname: Tang
authors.forename: Jill
authors.initials: J
authors.lastname: Milne