A prospective randomized trial using solvent dehydrated fascia lata for the prevention of recurrent anterior vaginal wall prolapse - 18/08/11
, Roger P. Goldberg, MD, MPH a, Christina Kwon, MD b, Sumana Koduri, MD a, Jennifer L. Beaumont, MS c, Yoram Abramov, MD a, Peter K. Sand, MD a
Reprint requests: Sanjay Gandhi, MD, Evanston Continence Center, Northwestern University Feinberg School of Medicine, 1000 Central St #730, Evanston, IL 60201.Abstract |
Objective |
This study was undertaken to compare outcomes after anterior colporrhaphy with and without a solvent dehydrated cadaveric fascia lata graft.
Study design |
A total of 162 women were enrolled in a prospective, randomized trial that evaluated the impact of a solvent dehydrated cadaveric fascia lata patch on recurrent anterior vaginal prolapse. Subjects were randomly assigned to standard colporrhaphy with or without a patch. Before and after surgery, subjects were evaluated by both the Baden-Walker and pelvic organ prolapse quantification systems. “Failure” was defined as stage II anterior wall prolapse or worse.
Results |
Of 154 women randomly assigned (76 patch: 78 no patch), all underwent surgery and 153 (99%) returned for follow-up. Sixteen women (21%) in the patch group and 23 (29%) in the control group experienced recurrent anterior vaginal wall prolapse (P=.229). Only 26% of all recurrences were symptomatic. Concomitant transvaginal Cooper's ligament sling procedures were associated with a dramatic decrease in recurrent prolapse (odds ratio [OR] 0.105, P < .0001).
Conclusion |
Solvent dehydrated fascia lata as a barrier does not decrease recurrent prolapse after anterior colporrhaphy. Transvaginal bladder neck slings were associated with a significant reduction in the risk of recurrent anterior wall prolapse.
Le texte complet de cet article est disponible en PDF.Key words : Recurrent vaginal prolapse, Graft material, Cadaveric fascia, Randomized trial, Cystocele, Anterior colporrhaphy
Plan
| Support from an unrestricted educational grant from Mentor Corp. Presented at the Joint Scientific Meeting of the Society of Gynecologic Surgeons and the American Urogynecologic Society, San Diego, Calif, July 29-31, 2004. |
Vol 192 - N° 5
P. 1649-1654 - mai 2005 Retour au numéro
Article précédent
- Histopathologic changes of porcine dermis xenografts for transvaginal suburethral slings
- Sanjay Gandhi, Lena M. Kubba, Yoram Abramov, Sylvia M. Botros, Roger P. Goldberg, Thomas A. Victor, Peter K. Sand
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