Skip to main content

Advertisement

SpringerLink
Log in

Anatomical outcome and quality of life following posterior vaginal wall prolapse repair using collagen xenograft

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate quality of life, sexual function, and anatomical outcome after posterior vaginal wall prolapse repair using a collagen xenograft. Thirty-three patients were evaluated preoperatively and at 6 and 12 months follow-up (FU). Quality of life and sexual function were assessed using a self-reported questionnaire. Prolapse staging was performed using the pelvic organ prolapse quantification system (POPQ). Preoperatively 3 patients had stage I, 26 patients stage II, and 4 patients stage III prolapse of the posterior vaginal wall. Prolapse of the posterior vaginal wall ≥ stage II was observed in 7 patients (21%) at the 6-month FU and in 13 patients (39%) at the 12-month FU. Mean point Bp was reduced from −1.1 preoperatively to −2.5 at 6 months FU (p<0.01) and −1.8 at 12 months FU (p<0.01). Previous abdominal surgery was associated with a less favorable anatomical outcome (odds ratio: 2.0, 95% confidence interval: 1.5–3.8). There were no significant changes in sexual function or dyspareunia during the 1-year FU. Preoperatively 76% of the patients reported a negative impact on quality of life as a result of genital prolapse. There was a significant improvement in several variables associated with quality of life at 6 and 12 months FU. Posterior vaginal wall prolapse repair using a collagen xenograft was associated with an unsatisfying anatomical outcome at 1-year FU although several quality of life-associated variables affecting psychosocial function were improved. Improvement was not restricted to postoperative restoration of vaginal topography, and previous surgery had a negative effect on anatomical outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Weber AM, Walters MD, Ballard LA, Booher DL, Piedmonte MR (1998) Posterior vaginal prolapse and bowel function. Am J Obstet Gynecol 179:1446–1449

    CAS  PubMed  Google Scholar 

  2. Bremmer S, Mellgren A, Holmstrom B, Lopez A, Uden R (1997) Peritoneocele: visualization with defecography and peritoneography performed simultaneously. Radiology 202:373–377

    CAS  PubMed  Google Scholar 

  3. Mellgren A, Bremmer S, Johansson C et al (1994) Defecography. Results of investigations in 2,816 patients. Dis Colon Rectum 37:1133–1141

    CAS  PubMed  Google Scholar 

  4. Karlbom U, Graf W, Nilsson S, Pahlman L (1996) Does surgical repair of a rectocele improve rectal emptying? Dis Colon Rectum 39:1296–1302

    CAS  PubMed  Google Scholar 

  5. Hirata H, Matsuyama H, Yamakawa G et al (2004) Does surgical repair of pelvic prolapse improve patients’ quality of life? Eur Urol 45:213–218

    Google Scholar 

  6. Francis W, Jeffcoate T (1961) Dyspareunia following vaginal operations. J Obstet Gynaecol Br Commonw 68:1–10

    Google Scholar 

  7. Weber AM, Walters MD, Piedmonte MR (2000) Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 182:1610–1615

    Article  CAS  PubMed  Google Scholar 

  8. Miklos JR, Kohli N, Moore R (2002) Levatorplasty release and reconstruction of rectovaginal septum using allogenic dermal graft. Int Urogynecol J Pelvic Floor Dysfunct 13:44–46

    Google Scholar 

  9. Liapis A, Bakas P, Pafiti A, Frangos-Plemenos M, Arnoyannaki N, Creatsas G (2001) Changes of collagen type III in female patients with genuine stress incontinence and pelvic floor prolapse. Eur J Obstet Gynecol Reprod Biol 97:76–79

    Google Scholar 

  10. Cervigni M, Natale F (2001) The use of synthetics in the treatment of pelvic organ prolapse. Curr Opin Urol 11:429–435

    Article  CAS  PubMed  Google Scholar 

  11. Iglesia CB, Fenner DE, Brubaker L (1997) The use of mesh in gynecologic surgery. Int Urogynecol J Pelvic Floor Dysfunct 8:105–115

    Google Scholar 

  12. Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    CAS  PubMed  Google Scholar 

  13. FitzGerald MP, Mollenhauer J, Bitterman P, Brubaker L (1999) Functional failure of fascia lata allografts. Am J Obstet Gynecol 181:1339–1344

    Google Scholar 

  14. Soergel TM, Shott S, Heit M (2001) Poor surgical outcomes after fascia lata allograft slings. Int Urogynecol J Pelvic Floor Dysfunct 12:247–253

    Article  Google Scholar 

  15. Kobashi KC, Mee SL, Leach GE (2000) A new technique for cystocele repair and transvaginal sling: the cadaveric prolapse repair and sling (CAPS). Urology 56:9–14

    Google Scholar 

  16. Groutz A, Chaikin DC, Theusen E, Blaivas JG (2001) Use of cadaveric solvent-dehydrated fascia lata for cystocele repair-preliminary results. Urology 58:179–183

    Article  Google Scholar 

  17. Gomelsky A, Rudy DC, Dmochowski RR (2004) Porcine dermis interposition graft for repair of high grade anterior compartment defects with or without concomitant pelvic organ prolapse procedures. J Urol 171:1581–1584

    Google Scholar 

  18. Salomon LJ, Detchev R, Barranger E, Cortez A, Callard P, Darai E (2004) Treatment of anterior vaginal wall prolapse with porcine skin collagen implant by the transobturator route: preliminary results. Eur Urol 45:219–225

    Google Scholar 

  19. Fitzgerald MP, Mollenhauer J, Brubaker L (1999) Failure of allograft suburethral slings. BJU Int 84:785–758

    Article  CAS  PubMed  Google Scholar 

  20. Nygaard I, Bradley C, Brandt D (2004) Pelvic organ prolapse in older women: prevalence and risk factors. Obstet Gynecol 104:489–497

    PubMed  Google Scholar 

  21. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104:1374–1379

    CAS  PubMed  Google Scholar 

  22. Filbeck T, Ullrich T, Pichlmeier U, Kiel HJ, Wieland WF, Roessler W (1999) Correlation of persistent stress urinary incontinence with quality of life after suspension procedures: is continence the only decisive postoperative criterion of success? Urology 54:247–251

    Google Scholar 

  23. Rothbarth J, Bemelman WA, Meijerink WJ et al (2001) What is the impact of fecal incontinence on quality of life? Dis Colon Rectum 44:67–71

    CAS  PubMed  Google Scholar 

  24. Haase P, Skibsted L (1988) Influence of operations for stress incontinence and/or genital descensus on sexual life. Acta Obstet Gynecol Scand 67:659–661

    Google Scholar 

  25. Weber AM, Walters MD, Schover LR, Mitchinson A (1995) Sexual function in women with uterovaginal prolapse and urinary incontinence. Obstet Gynecol 85:483–487

    Google Scholar 

  26. Mouritsen L, Larsen JP (2003) Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 14:122–127

    Google Scholar 

  27. Mellgren A, Anzen B, Nilsson BY et al (1995) Results of rectocele repair. A prospective study. Dis Colon Rectum 38:7–13

    CAS  PubMed  Google Scholar 

  28. Kahn MA, Stanton SL (1997) Posterior colporrhaphy: its effects on bowel and sexual function. Br J Obstet Gynaecol 104:82–86

    CAS  PubMed  Google Scholar 

  29. Lopez A, Anzen B, Bremmer S et al (2001) Durability of success after rectocele repair. Int Urogynecol J Pelvic Floor Dysfunct 12:97–103

    Google Scholar 

  30. Rogers RG, Kammerer-Doak D, Villarreal A, Coates K, Qualls C (2001) A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse. Am J Obstet Gynecol 184:552–558

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Obstetrics and Gynecology, Pelvic Floor Center, Danderyd Hospital, 18288, Stockholm, Sweden

    Daniel Altman, Annika López, Catharina Gustafsson, Christian Falconer & Jan Zetterström

  2. Division of Surgery, Karolinska Institutet, Danderyd Hospital, 18288, Stockholm, Sweden

    Johan Nordenstam

Authors
  1. Daniel Altman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annika López
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Catharina Gustafsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Falconer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Johan Nordenstam
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jan Zetterström
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel Altman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Altman, D., López, A., Gustafsson, C. et al. Anatomical outcome and quality of life following posterior vaginal wall prolapse repair using collagen xenograft. Int Urogynecol J 16, 298–303 (2005). https://doi.org/10.1007/s00192-005-1299-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-005-1299-0

Keywords

Search

Navigation