title: Biocompatible porcine dermis graft to treat severe cystocele: impact on quality of life and sexuality.
abstract: OBJECTIVE
  To study the quality of life (QoL) and sexual function changes of women affected by severe cystocele treated using biocompatible porcine dermis graft.
  
  
  METHODS
  20 women (ranging in age from 47 to 71 years, mean age 58.7) with third- and fourth-degree cystocele (according to Baden and Walker classification) were enrolled. The Short Form-36 questionnaire to assess QoL was administrated at baseline and 12 months after surgical treatment. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) to measure the changes of sexual behavior was used at baseline and 12 months after surgical treatment. Each woman underwent translabial color Doppler ultrasonography to measure the clitoral blood flow before and 12 months after surgical treatment.
  
  
  RESULTS
  Women reported QoL improvement (P < 0.001). By PISQ-12, improvement of the behavioral emotive factor score, the physical factor score, the partner-related factor score and of the total score during the 12-month follow-up with respect to baseline experience was observed (P < 0.001). Color Doppler measurement showed that the mean pulsatility index, peak systolic velocity, resistance index and end-diastolic velocity of clitoral arteries did not significantly change (P = NS).
  
  
  CONCLUSIONS
  Biocompatible porcine dermis graft to treat severe cystocele considerably improves QoL and sexual function, and does not influence clitoral blood flow. Our data could add new information about sexual behavior after prolapse treatment using this kind of graft, particularly about the impact on clitoral blood flow changes.
authors.affiliation: Department of Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy. vitalesalvatore@hotmail.com.
authors.forename: Salvatore Giovanni
authors.initials: SG
authors.lastname: Vitale
authors.affiliation: Department of Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Caruso
authors.affiliation: Department of Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Agnese Maria Chiara
authors.initials: AMC
authors.lastname: Rapisarda
authors.affiliation: Department of Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Valenti
authors.affiliation: Department of Obstetrics and Gynecology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Rossetti
authors.affiliation: Department of Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cianci
authors.affiliation: Department of Medical Surgical Specialties, Gynecology and Obstetrics Section, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cianci
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002987:Clitoris / Q000098:blood supply* / Q000000981:diagnostic imaging; D052858:Cystocele / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging; D011788:Quality of Life; D012725:Sexual Behavior; D019529:Sexuality / Q000502:physiology*; D016038:Skin Transplantation; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013552:Swine; D014183:Transplantation, Heterologous; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014549:Urinary Incontinence / Q000601:surgery
keywords: Clitoral blood flow; Color Doppler ultrasonography; Cystocele; Porcine dermis graft; Sexuality