title: Solvent-dehydrated dermal allograft (AXIS™) augmented cystocele repair: longitudinal results.
abstract: OBJECTIVE
  Surgical repair options for pelvic organ prolapse (POP) include native tissue, allograft, xenograft, and synthetic grafts. Solvent-dehydrated dermal allograft (SDDG) has an improved safety profile. We evaluated the long-term safety and efficacy of SDDG use for cystocele repair.
  
  
  METHODS
  A total of 184 patients completed a minimum follow-up of 12 months. Incontinence Impact Questionnaire (IIQ), Urogenital Distress Inventory (UDI), and Visual Analogue Scale (VAS) were used pre and post operatively. Recurrent cystocele grade ≥ II and/or repeat cystocele repair were considered objective failure.
  
  
  RESULTS
  Preoperatively, 17 patients (10%) had grade IV cystocele, 87 (47%) grade III, 70 (38%) grade II, and 10 (5%) grade I. All patients underwent SDDG cystocele repair with/without vaginal sling and/or POP repair and/or hysterectomy. Mean hospital stay was 0.58 days (range 0-4), mean estimated blood loss (EBL) was 111 mL, and mean length of Foley catheterization was 1.85 days (range 0-28). Postoperatively, 113 patients (64%) had no recurrent cystocele, 34 (19%) had grade I, 19 (11%) grade II, and 10 (6%) grade III cystocele. None had grade IV cystocele. Nineteen patients (10.3%) underwent repeat cystocele repair. Thirty-eight patients (21.6%) had postoperative recurrence (recurrent cystocele grade ≥ II and/or repeat cystocele repair). Dermal allograft related adverse events included 1 (0.5%) allograft vaginal exposure, dyspareunia 1 (0.5%), and transient hydronephrosis in 1 (0.5%). There were no vascular, vesical, visceral or neurological injuries.
  
  
  CONCLUSIONS
  These results indicate that SDDG augmented cystocele repair is a safe procedure, with low morbidity, and it's success is comparable to other techniques.
authors.affiliation: Incontinence Research Institute, 320 Santa Fe Dr Suite 108, Encinitas, CA, 92024, USA. urodawk@gmail.com.
authors.forename: Saad
authors.initials: S
authors.lastname: Juma
authors.affiliation: Department of Urology, University of California San Diego Health System, San Diego, CA, USA.
authors.forename: Omer A
authors.initials: OA
authors.lastname: Raheem
mesh_terms: D000368:Aged; D064591:Allografts / Q000637:transplantation*; D052858:Cystocele / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012867:Skin / Q000187:drug effects; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods*; D012997:Solvents; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
chemical_list: D012997:Solvents
keywords: Allograft; Cystocele; Dermal; Repair