title: Porcine Small Intestinal Submucosa Mesh for Treatment of Pelvic Organ Prolapsed.
abstract: BACKGROUND
  Pelvic organ prolapse (POP) is a major health concern that affects women. Surgeons have increasingly used prosthetic meshes to correct POP. However, the most common used is synthetic mesh, and absorbable mesh is less reported. This research aimed to evaluate the clinical effectiveness of porcine small intestinal submucosa (SIS).
  
  
  METHODS
  Consecutive forty POP patients who met the inclusion criteria underwent pelvic reconstruction surgery with SIS between March 2012 and December 2013. The patients' clinical characteristics were recorded preoperatively. Surgical outcomes, measured by objective and subjective success rates, were investigated. We evaluated the quality of life (QOL) using the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). Sexual QOL was assessed by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12).
  
  
  RESULTS
  At postoperative 12 months, the subjective recurrence rate (7.5%) was much lower than the objective recurrence rate (40.0%). Postoperatively, no erosion was identified. One underwent a graft release procedure because of urinary retention, and one had anus sphincter reconstruction surgery due to defecation urgency. Another experienced posterior vaginal wall infection where the mesh was implanted, accompanied by severe vaginal pain. Estrogen cream relieved the pain. One patient with recurrence underwent a secondary surgery with Bard Mesh because of stage 3 anterior vaginal wall prolapse. Scoring system of PFDI-20 was from 59.150 ± 13.143 preoperatively to 8.400 ± 4.749 postoperatively and PFIQ-7 was from 73.350 ± 32.281 to 7.150 ± 3.110, while PISQ-12 was from 15.825 ± 4.050 to 12.725 ± 3.471.
  
  
  CONCLUSIONS
  QOL and the degree of subjective satisfaction were significantly improved postoperatively. Anterior repair deserves more attention because of the higher recurrence rate. The long-term follow-up of the patient is warranted to draw firm conclusion.
authors: Department of Gynecology, Peking University People's Hospital, Beijing 100044, China.
authors: Ting-Ting
authors: TT
authors: Cao
authors: Department of Gynecology, Peking University People's Hospital, Beijing 100044, China.
authors: Xiu-Li
authors: XL
authors: Sun
authors: Department of Gynecology, Peking University People's Hospital, Beijing 100044, China.
authors: Shi-Yan
authors: SY
authors: Wang
authors: Department of Gynecology, Peking University People's Hospital, Beijing 100044, China.
authors: Xin
authors: X
authors: Yang
authors: Department of Gynecology, Peking University People's Hospital, Beijing 100044, China.
authors: Jian-Liu
authors: JL
authors: Wang
mesh_terms: D000368:Aged; D000818:Animals; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D013526:Surgical Mesh; D013552:Swine; D054457:Tissue Scaffolds