title: Treatment of total pelvic organ prolapse using a whole biological patch: A pilot study of 17 patients.
abstract: OBJECTIVE
  A complete and non-splice porcine small-intestine submucosa (SIS) patch was used for total pelvic anatomical repair of organ prolapse.
  
  
  METHODS
  This study included a total of 17 patients with severe total pelvic organ prolapse, including five patients with combined stress urinary incontinence (SUI). Panhysterectomy was performed, and then a porcine SIS patch was placed on the anterior (posterior) vaginal wall. The top of the vaginal wall was moved to the corresponding side of the vaginal wall, and the patch was sutured to bilateral uterosacral ligaments, the sacrospinous ligament, and arcus tendineus fasciae pelvis. SUI was addressed at the same time. 'Failure' was defined as anterior or posterior wall prolapse beyond the hymen.
  
  
  RESULTS
  The mean follow-up duration was 11.6 ± 7.45 months (2-24 months). No symptom recurrence was observed in the five patients with combined SUI. One patient who underwent porcine SIS patch placement on the posterior wall experienced stage II anterior vaginal wall prolapse after surgery. The vaginal wall and fornix of the remaining patients with patches were restored to stable anatomical positions (92.85%). No organ damage, infection, erosion, or rejection was observed, and no blood transfusion was necessary.
  
  
  CONCLUSIONS
  This study is the first to implement total pelvic anatomical repair using a complete and non-splice SIS. Our results suggest that this new surgical method is safe and can achieve satisfactory therapeutic effects, especially for patients with combined SUI.
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Jishuital Hospital, Beijing, China.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Obstetrics and Gynecology, Beijing Jishuital Hospital, Beijing, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Beijing Research Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Yanwei
authors.initials: Y
authors.lastname: Lv
mesh_terms: D000368:Aged; D000818:Animals; D001672:Biocompatible Materials; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D010865:Pilot Projects; D011182:Postoperative Care; D011300:Preoperative Care; D011788:Quality of Life; D013552:Swine; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery; D014621:Vagina / Q000601:surgery
chemical_list: D001672:Biocompatible Materials
keywords: pelvic floor anatomy; pelvic organ prolapse; pelvic reconstructive surgery; porcine small-intestine submucosa; urinary incontinence