title: [Rectocele repair with porcine dermal collagen implant associated with infracoccygeal sacropexy].
abstract: OBJECTIVE
  To evaluate an infracoccygeal colpopexy procedure by tension-free synthetic tape for vaginal apical prolapse associated with a posterior mesh procedure using porcine dermal graft for rectocele repair.
  
  
  METHODS
  A retrospective study concerning 35 women. The surgical procedure included rectocele repair with porcine dermal collagen implant (porcine dermal matrix, native) associated with transgluteal infracoccygeal sacropexy using a polypropylene sling.
  
  
  RESULTS
  Median follow up was 48 months (42-54). A vaginal hysterectomy was associated in 43% and a cure of cystocele was associated in 63% of cases. No intra-operative complication was noted. The prevalence of dyschesia decreased from 25% (eight patients) preoperatively to 3% (one patient) postoperatively. No cases of de novo dyspareunia was noted. Five (14%) patients had a recurrent prolapse (two cases of rectocele stage 2, one case of grade 3 rectocele associated with a cystocele, a case of uterine prolapse associated with cystocele and one case of recurrent isolated uterine prolapse). Among them, three patients (9%) required a re-intervention for prolapse recurrence. No vaginal mesh exposure was observed. Perineal pain was reported by 12 (33%) patients at one month follow-up, but no patient complained with perineal pain one year follow-up.
  
  
  CONCLUSIONS
  Infracoccygeal sacropexy associated with rectocele repair using porcine dermal collagen implant was associated with satisfactory results at medium term follow-up.
authors.affiliation: Service de gynécologie obstétrique, CHU Caremeau, place du Professeur-Robert-Debré, 30000 Nîmes cedex, France. Vincent.go@wanadoo.fr
authors.forename: V
authors.initials: V
authors.lastname: Letouzey
authors.forename: L
authors.initials: L
authors.lastname: Panel
authors.forename: C
authors.initials: C
authors.lastname: Courtieu
mesh_terms: D000368:Aged; D000818:Animals; D001705:Bioprosthesis; D003050:Coccyx; D003094:Collagen; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D020047:Rectocele / Q000601:surgery*; D012189:Retrospective Studies; D016038:Skin Transplantation; D013526:Surgical Mesh; D013552:Swine
chemical_list: D003094:Collagen